Whereas Congress considers probably huge cuts to federal Medicaid funding, tribal well being leaders are bracing for a disaster.
Indian Nation has a novel relationship to Medicaid, as a result of this system helps tribes cowl persistent funding shortfalls left by the Indian Well being Service, the federal company accountable for offering well being care to Native Individuals.
With the associated Kids’s Well being Insurance coverage Program, Medicaid gives protection to greater than one million Native Individuals. The joint state-federal program additionally accounts for about two-thirds of non-IHS income for tribal well being suppliers. That revenue helps create monetary stability and covers some operational prices for tribal hospitals and clinics. Tribal leaders need an exemption from any cuts and are making ready for a struggle to protect their entry.
“Medicaid is likely one of the methods wherein the federal authorities meets its belief and treaty obligations to supply well being care to us,” mentioned Liz Malerba, director of coverage and legislative affairs for the United South and Japanese Tribes Sovereignty Safety Fund, a nonprofit advocacy group for 33 tribes spanning from Texas to Maine. Malerba is a citizen of the Mohegan Tribe.
“So we view any disruption or lower to Medicaid as an abrogation of that duty,” she mentioned.
Final month, the Home permitted a price range decision that requires lawmakers to chop spending to offset tax breaks. The Home Committee on Power and Commerce, which oversees spending on Medicaid, is instructed to slash $880 billion over the following decade.
The IHS tasks that it’s going to invoice Medicaid about $1.3 billion this fiscal 12 months, which represents lower than half of 1% of total federal spending on Medicaid.
If Congress makes huge cuts to this system, tribal well being amenities will possible have to cut back companies for a inhabitants that experiences extreme well being disparities, a excessive incidence of persistent sickness, and a shorter life expectancy.
“Whenever you’re speaking about someplace between 30% to 60% of a facility’s price range is made up by Medicaid {dollars}, that’s a really troublesome gap to attempt to backfill,” mentioned Winn Davis, congressional relations director for the Nationwide Indian Well being Board.
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