Congress Mulls Potentially Massive Cuts to Federal Medicid Funding, Health Centers That serves Native American Communities, Such As the Oneida Community Health Center Near Green Bay, Wisconsin, Are Bracing for Castrophe.
That’s BECAUSE more than 40% of the About 15,000 Patients The Center Serves are Enrolled in Medicaid. Cuts to the Program Would be detrimental to Those Patients and the Facility, Said Debra Danforth, The Director of the Oneida Comparthensive Health Division and A Citizen of the Oneida Nation.
“It will be a tremendous hit,” She Said.
The Facility Provides the Range of Services to Most of the Oneida Nation’s 17,000 People, Including Ambulatory Care, Internal Medicine, Family Practice, and Obstetrics. The Tribe is one of Two in Wisconsin That Have an “Open-Door Policy,” Danforth Said, Which Means That the Facility Is Open To Members of Any Federally Recognized Tribe.
But Danforth and Many other tribal health officer Say Medicaid Cuts WOULD CAUSE SERVICE REDUCTIONS AT HEALTH FACILITIES THAT Serve Native Americans.
Indian country has a unique relationship to medicaid, BECAUSE the Program Helps Tribes Cover Chronic Funding Shortfalls from the Indian Health Service, The Federal Agency Responsible for Providing Health Care to Native Americans.
MEDICAID HAS ACCOUNTED FOR ABOUT TWO-TIRDS Of Third-Party Revenue for tribal health provides, Creating Financial Stability and Helping Facilities Pay Operational Costs. More than Million Native Americans Enrolled in Medicaid or the Closeed Related Children’s Health Insurance Program Also Rely on the Insurance to Pay For Care Outside of Tribal Health Facilities Without Going Into Significant Medical Debt. TRBAL LEADERS ARE CALLING ON CONGRESS TO EXEMPT TRIBES FROM CUTS AND ARE PREPARING TO FIGHT TO PRESERVE THEIR ACESS.
“Medicaid is one of the ways in Which the federal government meets its trust and treaty obligations to provide health to us,” Said Liz Malerba, Director of Policy and Legislative affairs for the united south and eastern tribes Sovereignty Protection Fund, the nonprofit polycy advocacy organizational for 33 tribs spanning from Texas to Maine. Malerba is a citizen of the Mohegan Tribe.
“So We View Any Disruption or Cut To Medicaid as an Abrogation of That Responsibility,” She Said.
Tribes Face An Arduous Task in Providing Care to a Population That Experiences Severe Health Fixes, the High Incidence of Chronic Illness, and, at Least in Western States, A Life Expectancy of 64 Years – The Lowest of Any Demographic Group in the US Yet, in Recent YEars, Some Tribes have Expanded Access to Care For Their Communities by Adding Health Services and Providers, Enabled in Part by Medicaid Reimbursements.
During the Last Two Fiscal Years, Five Urban Indian Organizations in Montana Saw Funding Growth of Nearly $ 3 Million, Said Lisa James, Director of Development for the Montana Consortium for Urban Indian Health, DURING A WEBINAR In February Organized by the Georgetown University Center for Children and Families and the National Council of Urban Indian Health.
The Increaded Revenue was “instrumental,” James Said, Allowing Clinics in the State to Add Services That Previously Had Not Been Available Unless Referred Out for, Including Behavioral Health Services. Clinics Were Also Able to Expand Operating Hours and Staffing.
Montana’s Five Urban Indian Clinics, in Missoula, Helena, Butte, Great Falls, and Billings, serves 30,000 People, Including Some Who are not Native American or Enrolled in Triba. The Clinics Provide the Wide Range of Services, Including Primary Care, Dental Care, Disease Prevention, Health Education, and Substance Use Prevention.
James Said Medicaid Cuts Would Require Montana’s Urban Indian Health Organizations to Cut Services and Limit Their Ability to Address Health Fixes.
American Indian and Alaska Native People Under Age 65 Are More Likely to Be Uninsured Than White People Under 65, But 30% Rely on Medicaid Compred with 15% of Their White Counterparts, According to Kff date for 2017 to 2021. More than 40% of American Indian and Alaska Native Children are Enrolled in Medicaid or Chip, Which Provides Health Insurance to Kids Whiters are not eligible for medicaid. KFF is a health information nonprofit that includes Kff Health News.
Georgetown Center for Children and Families Report from january Found the Share of Residents Enrolled in Medicaid was Higher in Counties with a Significant Native American Presence. The Proportion on Medicaid in Small-Town or Rural Counties That Are Mostly Within Tribal Statistical Areas, Tribal Subdivision, Reserves, and Other Native-Designated Lands Was Was 28.7%, Compred with 22.7% In other Small-Town or Rural Counties. About 50% of Children in Those Native Areas Were Enrolled in Medicaid.
The Federal Government has already exempted tribes from some of trump’s executive orders. In Late February, Department of Health and Human Services Acting General Counsel Sean Keveney Clarified that tribal health program not be affected by AN EXECUTIVE ORDER That diversity, equity, and Inclusion Government Programs be finished, but that the Indian Health Service is expected to discontinue diversity and Inclusion Hiring Efforts Established Under an Obama-Era Rule.
HHS Secretary Robert F. Kennedy Jr. Also Rescinded The Layoffs Of more than 900 iHs Employees in February Just Hours After They’d Received Termination Notices. During Kennedy’s Senate Confirmation Hearings, he said he will appoint a native American as an assistant hhs secretary. The National Indian Health Board, Washington, DC-Based Nonprofit That Advocates for Tribes, In December EndorSed Elevating the Director of the Indian Health Service to Assistant Secretary of HHS.
Jessica Schubel, Senior Health Care Official in Joe Biden’s White House, Said Exemptions Won’t Be Enough.
“Just Because Native Americans are exempt doesn’t mean that they won´t Feel the impact of cuts that are made Throughout the rest of the program,” She Said.
STATE LEADERS ARE ALSO Calling for Federal Medicid Spending to be Spared Because Cuts to the Program Would Shift Costs Onto Their Budgets. Without Sustained Federal Funding, Which Can Cover More Than 70% of Costs, State Lawmakers Decisions Such As When to Change Eligibility Requirements To Slim Medicid Rolls, Which Could Cause Native Americans to Lose Their Health Coverage.
TRBAL LEADERS NOTED THAT STATE GOVERNMENTS FROM NOT HAVE THE SAME CAREWORD TO THEM AS FEDERAL GOVERNMENT, YET THEY FACE VARIATIONS IN HOW THEY INTERACT WITH MEDICAID DEPENDING ON THEIR STATE PROGRAMS.
President Donald Trump has made SEMEMINGLY CONFLICTING STATMENTS About Medicaid Cuts, Saying in An Interview on Fox News in February That Medicaid and Medicare Woldn’t Be Touched. In Social Media Post the Same Week, Trump Expressed Strong Support for House Budget Resolution That WOULD LIKELY REQUIRE MEDICAID CUTS.
The Budget Proposal, Which the House Approved in Late February, Requires Lawmakers to Cut Spending to Offset Tax Breaks. The House Committee on Energy and Commerce, Which Overses Spending on Medicaid and Medicare, IS Instruction to Slash $ 880 Billion over the next decade. The possibilities of cuts to the program that, together with chip, provides insurance to 79 Million People has Drawn opposition From National and State Organizations.
The Federal Government Reimburses IHS and Tribal Health Facilities 100% of Billed Costs For American Indian and Alaska Native Patients, Shielding State Budgets from the Costs.
BECAUSE MEDICAID IS ALREADY A STOPGAP FIX FOR NATIVE AMERICAN HEALTH PROGRAMS, TRBAL LEADERS SAID IT WON’T BE A MATTER OF REPLACING THE MONEY BUT OPERATING WITH LESS.
“When You’re Talking About Somewhere Between 30% to 60% of a Facility’s Budget is Made Up by Medicaid Dollars, that’s a Very Difficult Hole to Try and Backfill,” Said Winn Davis, Congressional Relations Director for the National Health Board.
CONGRESS ISN’T REQUIRED TO CONSULT TRIBES DURING THE BUDGET PROCESS, DAVIS ADDED. Only After Changes Are Made by the centers for Medicare & Medicaid Services and State Agencies are tribes able to engage with on implementation.
The Amount the Federal Government Spends Funding the Native American Health System is a Much Smaller Portion of its Budget Than Medicid. The IHS Projected Billing Medicaid About $ 1.3 Billion This tax year, Which Representa Less Than Half of 1% of Overall Federal Spending on Medicaid.
“We Are Saving More Lives,” Malerba Said of the AddiThe Services Medicaid Covers in Tribal Health Care. “It brings us closer to a level of 21st century care that we shat all have Access to But Don’t Always.”
This article was published with the support of the Journalism & Women Symposium (JAWS) Health Journalism Fellowship, Assisted by Grants from the Commonwealth Fund.
Kff Health News is a National Newsroom that produce in-dephi journalism about health issues and is one of the core operating programs at kff-a independent source of health polycy research, polling, and journalism. Learn More About Kff.
Use our content
This story can be republicated for free (details).
By Jazmin Orozco RodriguezKaiser Health News is a nonprofit News Service Covering Health Issues. IT IS AN EDITORIALLY INDEPENDENT PROGRAM OF THE KAISER FAMILY FOUNDATION, WHICH IS NOT AFFILIED WITH KAISER PERMANENT.
