Commentary: Today, U.S. Senator Tom Udall, vice chairman of the Senate Committee on Indian Affairs, will offer an amendment to protect against cuts to health care for Indian Country as a result of the Republican effort to repeal the Affordable Care Act (ACA) and roll back Medicaid funding.
Among the many serious problems with repealing the ACA are that it would result in severe cuts to Medicaid and have a serious impact on the Indian Health Service (IHS). Udall opposes repealing the ACA, and his amendment would protect health care for Indian Country by effectively exempting the Indian Health Service and other Tribal health providers from Medicaid cuts if Republicans succeed in repeal.
The measure will be voted on tonight as part of the so-called "vote-a-rama" as the Senate debates numerous amendments in the effort to dismantle the Affordable Care Act. It is cosponsored by Senators Martin Heinrich (D-N.M.), Maria Cantwell (D-Wash.), Al Franken (D-Minn.), Heidi Heitkamp (D-N.D.), Patty Murray (D-Wash.), Brian Schatz (D-Hawaii), Jon Tester (D-Mont.), and Ron Wyden (D-Ore.). The amendment is also supported by the National Congress of American Indians, the National Indian Health Board, and the National Council of Urban Indian Health.
“The Medicaid expansion under the Affordable Care Act has helped to fulfill our federal government’s trust responsibility to provide health care to Tribes,” Udall said. “Any reduction in federal payments to the Indian health system would jeopardize the lives and well-being of American Indians and Alaska Natives, as most health care facilities that serve Native Americans are already woefully underfunded. The Medicaid expansion has enabled IHS to provide critical, life-saving services like surgeries and preventative care, and attempts to strip away these services from Tribal communities by repealing the Affordable Care Act are unconscionable. My amendment is essential for protecting the health care of American Indians and Alaska Natives against reckless repeal efforts.”
“The expansion of Medicaid, as a result of the Affordable Care Act, has made a tremendous impact in New Mexico and across Indian Country. If Republicans go forward with their 'Repeal and Run' maneuver, Native Americans who have some of the greatest barriers to consistent access to preventative and emergency medical care would pay the price,” Heinrich said. "I continue to hear from New Mexicans about how access to health care coverage has helped their families and even saved their lives. A reckless repeal would quickly throw our state’s health care system into chaos and strip critical funding from Indian Health Service and other Tribal health providers, which are already severely underfunded. I am proud to join Senator Udall in this effort to stand up for our Tribal communities who depend on this lifesaving coverage.”
The Indian Health Service is a federally funded health care system that serves as a primary source of health care for American Indians and Alaska Natives. Yet the IHS is persistently and severely underfunded, with current federal funding covering less than half of the operational costs of IHS care facilities, and IHS spending per patient less than 38 percent of the national average. As a result of inadequate federal support for IHS, a large percentage of Tribal members rely on Medicaid to fulfill their health care needs – including 132,000 Tribal members who are enrolled in Medicaid in New Mexico. The expansion of Medicaid under the ACA has provided the IHS, Tribes, Tribal organizations, and Urban Indian Organizations with crucial revenue to support expanded access to care across Indian Country.
In a letter to Udall, the All Pueblo Council of Governors, which represents all 19 New Mexico Pueblos, strongly opposed any attempt to roll back the Medicaid expansion and repeal the historic protections of the Affordable Care Act. As Chairman of the All Pueblo Council of Governors E. Paul Torres Wrote, “Pueblo leaders are concerned that a number of the ACA-related proposals would sunset Medicaid expansion, which has provided desperately needed funding to supplement inadequate Indian Health Service budgets.”