Self-Governance Communication & Education Tribal Consortium

Tribal Legislative Priorities on Medicaid

The Medicaid program is a critical component of the Indian health system.

Medicaid resources now account for nearly 13 percent of total funding for the Indian Health Service (IHS), and an even greater amount for Tribally-operated health programs. Yet, total IHS Medicaid reimbursements account for only a fraction of a percent of total Medicaid spending nationwide.

Congress intended that Medicaid resources serve “as a much-needed supplement to a health care program which for too long has been insufficient to provide quality health care to the American Indian.” Tribes and IHS providers bill Medicaid for services which supplements very limited IHS appropriations.

But, access to Medicaid has been uneven across Indian country.

Medicaid is a jointly funded federal-state program that is managed by the individual states under certain federal parameters. Depending on the state they are located, IHS and Tribal programs have varying levels of access to Medicaid resources and services. This means that the Medicaid program is not providing equal access to Medicaid services for Indian people.

The proposed Equal Access to Medicaid for All American Indians and Alaska Natives Act (Act) is intended to provide greater access to and responsiveness of the Medicaid program for the Indian health system, while at the same time reducing regulatory burdens and costs on the states.


For more information:

Overview of Legislative Proposal

Tribal Resolutions of Support

Presentation to TSGAC

NIHB Resolution (SAMPLE)

Background Research on Cost Estimate