June 23, 2017

Udall Calls TrumpCare ‘Catastrophic’ for Indian Country

WASHINGTON — Today, U.S. Senator Tom Udall, vice chair of the Senate Committee on Indian Affairs, released the following statement on the devastating effects of the Senate TrumpCare bill on Native Americans’ access to life-saving health care services:
“Native Americans would be among those hardest hit by this disastrous Senate TrumpCare bill. As vice chair of the Senate Indian Affairs Committee, I’ve heard from many Tribes who are deeply concerned about the lack of Tribal consultation in TrumpCare – and about how devastating this bill would be for access to life-saving health care services in Indian Country.
“The Affordable Care Act has helped to fulfill our federal government’s trust responsibility by providing much needed resources to fill the funding gap facing Tribal health facilities. Many Native Americans get care through the Indian Health Service, but IHS has not always been able to provide needed services due to a persistent lack of funding. As a result, IHS facilities are heavily dependent on third-party collections – through programs like Medicaid – for clinical services. Fortunately, the Medicaid expansion in the Affordable Care Act has greatly increased revenue for IHS facilities, directly leading to increased access to care in Indian Country. The Medicaid expansion has enabled IHS facilities to provide key health services to Native Americans above the ‘life and limb only’ level.
“But TrumpCare destroys all the progress Tribes have seen under the Affordable Care Act – ending the Medicaid expansion, reducing support for private insurance, and thus greatly reducing Native Americans’ access to health care. This bill would be catastrophic for Indian Country, and I’m going to keep fighting in the Senate to defeat it.”
At a recent hearing of the Senate Indian Affairs Committee, Udall questioned Acting IHS Director Chris Buchanan about how a rollback of the Medicaid expansion would hurt IHS’ delivery of health care in Indian Country. Buchanan testified that IHS Medicaid reimbursements have increased 21 percent between 2012 and 2016 and that all IHS service regions are now able to pay for medical services above the “life and limb only” level. Responding to Udall’s question, Buchanan confirmed these increases were linked to billing increases brought by the ACA’s Medicaid expansion. Further pressed by Udall, Buchanan confirmed that a rollback of the Medicaid expansion would severely hamper IHS’ health care delivery advancements.
With the expansion of Medicaid, third-party billing for Medicaid services provided at IHS facilities brought in more than $800 million in revenue by Fiscal Year 2016. These Medicaid funds have allowed the majority of IHS Service Areas to move from “life and limb only” care to offering preventative and primary care services. Currently, Medicaid reimbursements represent 67 precent of third-party revenues at IHS, and provide 13 percent of IHS’ total operating budget.