Tag Archive for: Medicare/Medicaid

NCUIH Releases New Resource Highlighting Medicaid’s Crucial Role for American Indian and Alaska Native Communities

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The National Council of Urban Indian Health (NCUIH) has released a comprehensive overview highlighting the crucial role Medicaid plays in providing health care to American Indian and Alaska Native (AI/AN) communities. This report emphasizes the importance of preserving Medicaid resources and exempting AI/AN beneficiaries from work requirements to fulfill the federal government’s trust responsibility.

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NCUIH Releases New Resource Highlighting Medicaid's Crucial Role for AI/AN Communities

  • Approximately 2.7 million AI/AN people are enrolled in Medicaid, with 24% of AI/AN adults aged 18-64 and 23% of those over 64 benefiting from the program.
  • Almost 49% of AI/AN children are enrolled in Medicaid.
  • Urban Indian Organizations serve as vital health care providers.
    • 59% of AI/AN people receiving care at UIOs are Medicaid beneficiaries.
    • Eight out of the top ten states with the largest number of AI/AN Medicaid beneficiaries have UIOs providing essential services.

Call to Action

Preserve Medicaid Resources

  • Cuts to Medicaid would severely impact AI/AN health care access, necessitating state funding gaps and reducing essential services like diabetes programming and cancer screenings.

Exempt AI/AN Beneficiaries from Work Requirements:

  • Mandatory work requirements would disproportionately affect AI/AN beneficiaries due to unique economic challenges. Exemption is crucial to protect health care access, consistent with the Indian Health Care Improvement Act.

Percentage of American Indian and Alaska Native Population on Medicaid by State and Age Range:

Below is a table of Medicaid data for the AI/AN population, based on the American Community Survey data (2023, 1-year estimate).

State 0-18 % of AI/AN Pop on Medicaid  19 – 64 % of AI/AN Pop on Medicaid 65+ % of AI/AN Pop on Medicaid
Alabama 58.84 14.97 22.11
Alaska 55.85 36.74 33.21
Arizona 48.31 29.57 30.78
Arkansas 47.24 23.11 16.94
California 47.16 26.66 26.25
Colorado 49.51 26.06 27.58
Connecticut 44.46 37.48 19.05
Delaware 56.56 21.19 20.40
District of Columbia 31.99 4.85 24.97
Florida 39.17 13.3 20.23
Georgia 44.67 12.10 16.88
Hawaii 44.49 25.28 20.44
Idaho 29.99 23.67 15.58
Illinois 47.78 19.71 17.96
Indiana 46.63 28.09 23.48
Iowa 54.32 23.95 19.33
Kansas 39.11 14.84 19.97
Kentucky 61.44 32.86 23.60
Louisiana 50.16 28.86 22.90
Maine 62.81 36.51 29.80
Maryland 40.43 17.56 19.58
Massachusetts 51.09 37.18 41.82
Michigan 47.32 29.74 16.24
Minnesota 50.35 32.43 14.18
Mississippi 65.29 14.60 26.81
Missouri 55.78 20.56 19.62
Montana 68.30 42.37 26.44
Nebraska 52.94 25.51 28.72
Nevada 41.06 22.72 19.65
New Hampshire 51.70 24.62 35.66
New Jersey 57.23 19.83 10.63
New Mexico 71.65 43.62 35.09
New York 49.32 30.94 33.53
North Carolina 57.28 21.29 23.66
North Dakota 63.34 37.79 17.69
Ohio 46.73 27.70 27.55
Oklahoma 51.42 21.62 17.18
Oregon 59.71 33.21 25.83
Pennsylvania 50.85 32.67 30.96
Rhode Island 46.77 25.63 16.85
South Carolina 40.89 18.65 18.50
South Dakota 60.30 26.67 30.01
Tennessee 51.66 22.20 22.64
Texas 35.10 9.37 16.87
Utah 29.98 20.95 18.67
Vermont 73.74 33.13 24.74
Virginia 37.40 21.24 13.27
Washington 49.27 27.90 18.98
West Virginia 45.81 32.73 10.62
Wisconsin 53.46 27.34 15.72
Wyoming 52.42 19.57 15.07
All States + DC 48.68 24.22 22.97

NCUIH Joins Coalition in Urging Bipartisan Support for Medicaid and CHIP Programs

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On March 3, 2025, the National Council of Urban Indian Health (NCUIH) joined 30 national and state level provider groups, health plan associations, and patient advocacy groups in signing on to the Medicaid Health Plans of America (MHPA) letter to the Chairs and Rankings Members of the Senate Finance and House Energy & Commerce Committees, expressing strong support for the importance of Medicaid and the Children’s Health Insurance Program (CHIP).

Medicaid provides health coverage to more than 80 million Americans, including working families, children, seniors, and people with disabilities. It plays a key role in ensuring that people have access to doctors, hospitals, and treatment when they need it. In 2023, approximately 2.7 million Native people were enrolled in Medicaid across the United States, according to American Community Service data. Medicaid is a major source of health care funding, particularly for Urban Indian Organizations (UIOs), which provide essential healthcare services to Native people living in urban areas. The letter emphasizes the importance of Medicaid and CHIP as a source of funding for critical safety net facilities and encourages Congressional leadership to continue in a tradition of bipartisan support for these vital programs.

NCUIH remains committed to working with policymakers to support a strong Medicaid program.

Read the letter here.

Full Letter Text

March 3, 2025

The Honorable Mike Crapo, Chairman, Committee on Finance, U.S. Senate
The Honorable Brett Guthrie, Chairman, Energy and Commerce Committee, U.S. House of Representatives The Honorable Ron Wyden, Ranking Member, Committee on Finance, U.S. Senate
The Honorable Frank Pallone, Ranking Member, Energy and Commerce Committee, U.S. House of Representatives

Dear Congressional Leaders,

As a coalition of stakeholders serving individuals relying on the Medicaid and Children’s Health Insurance Programs (CHIP), we write to convey the critical importance of these programs, and to encourage you to continue to strengthen both in the years to come. The flexibility, efficiency and positive impact of Medicaid in every state across the country is a hallmark of how federal-state partnerships can deliver results tailored to local needs.

As you know, Medicaid serves a broad spectrum of Americans across all walks of life, including children, mothers, the aged, blind and disabled, individuals with substance use disorder (SUD), persons with mental health conditions and mental illness, and low-income individuals, all of whom depend on the program to provide them with access to health care services and life-saving treatments.

Medicaid shines as a bright example of what can be accomplished when the Federal government works with state partners to deliver for the American people. The flexibility and accountability of the program enables efficient coverage for over 79 million individuals in 50 states and the District of Columbia, as of October 2024. The Medicaid program allows states the ability to tailor their programs to meet the needs of their unique populations, while creating efficiencies and innovations that might not be possible in other delivery systems.

With the ability to design their own programs, states have leveraged the Medicaid program to ensure access to care for our most vulnerable populations; populations that would have no other source of insurance coverage. Individuals with disabilities rely on the Medicaid program to receive long-term services and supports, both at in person nursing facilities and through home and community-based services, allowing them to find employment and serve as active members of their communities. Medicaid plays a key role in providing mental health and SUD services, as 40% of the nonelderly adult Medicaid population (13.9 million enrollees) had a mental health condition or SUD in 2020. And more than 37 million children receive health coverage through Medicaid and CHIP, representing 47.4% of overall Medicaid and CHIP program enrollment. Nearly two out of every three adult women enrolled in Medicaid are in their reproductive years, and Medicaid currently covers about 42% of all births in the United States. Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit keeps children healthy and provides them with critical behavioral health services. EPSDT is also a benefit with strong bipartisan support that was recently strengthened by the Safer Communities Act.

In addition to the vulnerable populations covered by Medicaid, it is a crucial source of coverage for many safety net facilities and the clinicians relied on by patients in these settings. Insurance coverage through Medicaid ensures that our safety net facilities, including rural hospitals, health centers, mental health centers, nursing homes, critical access hospitals, and others, remain open and can provide primary and specialty care services, as well as 24/7 emergency care, to the communities surrounding them. Without comprehensive Medicaid coverage these facilities may be forced to close, and millions of people would need to travel hundreds of miles to access a health care facility to receive necessary care from trusted clinicians.

It is vital that Medicaid and CHIP continue to receive strong support from the Federal government, so that the program can continue to serve mothers, children, the aged, blind and disabled, individuals with SUD, persons with mental health conditions and mental illness, and low-income Americans, all who depend on the program to stay healthy and to receive life-saving treatments. Interruptions in health coverage, even temporary, have been shown to lead to a deterioration of 2 health conditions which later leads to higher costs for payers, challenging the sustainability of the program and making it more difficult for Americans depending on Medicaid to continue to work and contribute as members of their communities. Further, reductions in Medicaid funding could lead to hospital closures and reduced access to healthcare providers in rural and underserved areas, that are already struggling to meet the needs of their populations. Medicaid and CHIP have historically received bipartisan support, and we respectfully encourage you to continue this tradition, in order to strengthen and enhance this vital program serving millions of Americans across the country.

We sincerely thank you for your consideration and remain available to work with you and your colleagues to continue to meet the needs of the American people through a flexible, accountable, and efficient Medicaid program.

Respectfully,

National
Advocates for Community Health
Alliance of Community Health Plans
Allies for Independence
American Academy of Pediatric Dentistry
American Association of Nurse Practitioners
American Association on Health and Disability
American Dental Association
American Nurses Association
Association for Community Affiliated Plans
Association of Clinicians for the Underserved (ACU)
CommunicationFIRST
Federation of American Hospitals
Institute for Exceptional Care
Lakeshore Foundation
Medicaid Health Plans of America (MHPA)
National Association of Community Health Centers
National Association of Pediatric Nurse Practitioners
National Disability Rights Network (NDRN)
National Health Care for the Homeless Council
National MLTSS Health Plan Association
The National Council of Urban Indian Health

State
Access Living (Illinois)
Coalition of New York State Public Health Plans (New York)
Kentucky Association of Health Plans (Kentucky)
Local Health Plans of California (California)
Michigan Association of Health Plans (Michigan)
Minnesota Association of County Health Plans (Minnesota)
National Council on Independent Living (District of Columbia)
Ohio Association of Health Plans (Ohio)
Pennsylvania’s Medicaid Managed Care Organizations (PAMCO) (Pennsylvania)

NCUIH Supports the Partnership for Medicaid’s Call to Protect Medicaid and Access to Care

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The National Council of Urban Indian Health (NCUIH) joined the Partnership for Medicaid (P4M) in calling on Congress to protect Medicaid, while expressing a commitment to work with policymakers to identify more sustainable strategies to strengthen Medicaid and improve on its promise of providing high quality coverage and access to care for populations in need. On February 6, P4M issued a statement urging Congress to reject cuts to Medicaid during the budget reconciliation process, and on February 24, P4M released a statement urging Congress to vote “no” on the budget resolution which includes $880 billion in cuts for the Energy and Commerce Committee, which would likely significantly impact Medicaid.  

Medicaid provides health coverage to more than 80 million Americans, including working families, children, seniors, and people with disabilities. It plays a key role in ensuring that people have access to doctors, hospitals, and treatment when they need it. In 2023, approximately 2.7 million Native people were enrolled in Medicaid across the United States, according to American Community Service data. Medicaid is a major source of health care funding, particularly for Urban Indian Organizations (UIOs), which provide essential healthcare services to Native people living in urban areas. The proposed Medicaid cuts would threaten the ability of UIOs to sustain necessary service offerings, potentially reducing access to essential health care services for urban Native people. 

NCUIH remains committed to working with policymakers and UIOs to support a strong Medicaid program. 

About the Partnership for Medicaid 

NCUIH is a member of the Partnership for Medicaid, which is a nonpartisan, nationwide coalition of organizations representing clinicians, health care providers, safety-net health plans, and counties. The goal of the coalition is to preserve and improve the Medicaid program. 

 

PRESS RELEASE: NCUIH Celebrates CMS Approval of Medicaid Coverage for Traditional Healing Services, Emphasizes Importance for Urban Indian Organizations

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FOR IMMEDIATE RELEASE

“This approval is a testament to the tireless advocacy of Tribal leaders, Urban Indian Organizations, and our partners,” said Francys Crevier, J.D. (Algonquin), CEO of NCUIH. “It marks a historic milestone in our ongoing efforts to ensure that American Indian and Alaska Native people in urban areas have access to culturally appropriate, holistic care that honors our Traditional Healing practices”.

“As we’ve long advocated, the ability to provide and be reimbursed for culturally relevant services offers a greater opportunity to deliver whole-person care,” Crevier added. “This CMS approval is a crucial step towards health equity and honoring the rich traditions of our diverse Native communities, including those in urban areas”.

– NCUIH CEO, Francys Crevier (Algonquin)

Washington, D.C. (October 18, 2024) – The National Council of Urban Indian Health (NCUIH) enthusiastically welcomes Wednesday’s announcement by the Centers for Medicare & Medicaid Services (CMS) approving Medicaid coverage for Traditional Healing services in four states: California, Arizona, New Mexico, and Oregon.

This landmark decision represents a significant step forward in recognizing the value of culturally-based traditional health care practices for American Indian and Alaska Native people, including those living in urban areas.

Urban Indian Organizations and State-Specific Waivers

While the CMS approval is a significant step forward, it’s important to note that the implementation and coverage for Urban Indian Organizations (UIOs) varies by state:

  1. Arizona (AHCCCS):  Traditional Healing is covered for IHS and Tribal facilities. UIOs are not explicitly included as covered facilities. However, Traditional health care practitioners or providers at UIOs contracting with an IHS or Tribal facility could be included.
  2. California (CalAIM): California will have expenditure authority to provide coverage for traditional health care practices received through IHS, Tribal, or UIO facilities by Medicaid and CHIP beneficiaries who are able to receive services delivered by or through these facilities. The state will initially provide this coverage only to beneficiaries eligible to participate in the Drug Medi-Cal Organized Delivery system. However, California will have authority to expand coverage to all Medicaid beneficiaries who receive services delivered by or through an IHS, Tribal, or UIO facility.
  3. New Mexico (Turquoise Care): The state will have expenditure authority to provide coverage for Traditional Healing practices received through IHS, Tribes, or UIO facilities.
  4. Oregon (OHP): Traditional health care practices received through IHS, Tribal, or UIO facilities will be covered when provided to a Medicaid or CHIP beneficiary who is able to receive services delivered by or through these qualifying providers. State expenditures for Traditional Healing delivered at UIOs will receive the applicable state service match.

Next Steps

NCUIH will continue to work closely with CMS, state Medicaid programs, and UIOs to ensure smooth implementation of this new coverage and to advocate for equitable inclusion of UIOs in all states.

 

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative advocating for the 41 Urban Indian Organizations contracting with the Indian Health Service under the Indian Health Care Improvement Act. NCUIH is devoted to the support and development of quality, accessible, and culturally competent health and public health services for American Indians and Alaska Natives living in urban areas.

NCUIH respects and supports Tribal sovereignty and the unique government-to-government relationship between our Tribal Nations and the United States. NCUIH works to support those federal laws, policies, and procedures that respect and uplift Tribal sovereignty and the government-to-government relationship. NCUIH does not support any federal law, policy, or procedure that infringes upon or in any way diminishes Tribal sovereignty or the government-to-government relationship.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org