As Congress debates significant cuts to federal Medicaid funding, tribal health leaders are preparing for potential crisis in Indian Country. The unique relationship between tribes and Medicaid stems from the program’s role in covering funding shortfalls left by the Indian Health Service (IHS), the federal agency responsible for Native American healthcare.
Medicaid, along with the Children’s Health Insurance Program, provides coverage for over a million Native Americans and contributes to about two-thirds of non-IHS revenue for tribal health providers. This financial support creates stability and helps cover operational costs for tribal hospitals and clinics. Tribal leaders are advocating for an exemption from any cuts and are gearing up to protect their access to Medicaid.
Liz Malerba, director of policy and legislative affairs for the United South and Eastern Tribes Sovereignty Protection Fund, emphasized the importance of Medicaid in fulfilling the federal government’s trust and treaty obligations to provide healthcare to Native Americans. Any disruption or reduction in Medicaid funding would be seen as a failure to meet this responsibility.
The recent House-approved budget resolution mandates spending cuts to offset tax breaks, with the House Committee on Energy and Commerce instructed to slash $880 billion from Medicaid over the next decade. Despite Medicaid representing a small fraction of federal spending, the IHS relies on Medicaid billing for about $1.3 billion this fiscal year.
If significant cuts are made to Medicaid, tribal health facilities may be forced to reduce services for a population already facing severe health disparities, high rates of chronic illness, and a shorter life expectancy. With Medicaid accounting for a substantial portion of their budgets, backfilling the funding gap would be a major challenge for these facilities.
Winn Davis, congressional relations director for the National Indian Health Board, highlighted the impact of Medicaid cuts on tribal health services. The potential loss of 30% to 60% of a facility’s budget from Medicaid dollars would pose significant challenges in maintaining quality care for Native American communities.
As tribes continue to advocate for protection of their Medicaid access, the future of healthcare in Indian Country hangs in the balance. It is crucial for policymakers to consider the unique healthcare needs of Native Americans and ensure that funding cuts do not further exacerbate existing health disparities.
