Health Care Reform in the 115th Congress
NIHB Board Members Deliver Remarks to Members of the Senate Committee on Indian Affairs about Tribal Health Reform Priorities
In 2017, Congress considered major changes to the American healthcare system, greatly impacting Tribal healthcare delivery systems. Ultimately, neither the House’s American Health Care Act (AHCA) nor the Senate’s Better Care Reconciliation Act (BCRA) became law. In 2018, Congress likely will continue to evaluate less comprehensive reforms to the American healthcare system. You can read below on the work NIHB did in 2017, what we hope to accomplish in 2018, and how YOU can use your voice to advocate for Tribal health.
The National Indian Health Board actively engaged Congress throughout 2017 on behalf of all 567 federally-recognized Tribes. NIHB educated Tribal leaders on the potential impacts the proposals would have on Tribal healthcare delivery systems and expressed Tribal concerns with the legislation to Congress. The policies outlined called for significant changes to the health insurance markets, health insurance subsidies, penalties and the Medicaid program. The proposed Medicaid per capita caps, shortened enrollment periods into health care insurance, and implementation of a series of age-based tax credits for securing coverage were a great departure from models seen under the ACA. NIHB and other Tribal organizations sent letters to Congress outlining the Tribal priorities for health reform:
- Maintain Medicaid funding based on need, rather than capping it according to a complicated per capita allocation formula or through capped block grants.
- Continue Medicaid Expansion, and at the very least, continue Medicaid Expansion for AI/ANs
- Protect AI/ANs from barriers to care that are inconsistent with the federal trust responsibility, such as work requirements under Medicaid
- Retain cost-sharing protections at Section 1402 of the Patient Protection and Affordable Care Act (ACA); and
- Maintain funding for preventative services, including the Prevention and Public Health Fund and women’s health services.
Though the legislation did not become law, it is still important for Indian Country to remain vigilant about these proposals. Please use the following resources developed by NIHB. All documents are PDFs unless otherwise noted.
Senate Legislation (BCRA)
- NIHB Letter on Senate BCRA
- NIHB Health Care Reform Reference Guide: BCRA, AHCA, ACA
- NIHB -NCAI Letter on Senate Healthcare Reform Legislation
House Legislation (AHCA)
In 2018, Congress will examine ways to stabilize the insurance marketplaces, which many American Indians and Alaska Natives utilize, and ways to reduce the costs of premiums. Please use these resources below to help us protect the Tribal healthcare system and make it stronger.
Tribal Priorities
Background Materials
- NIHB and NCAI Letter on Medicaid Reform
- Why Medicaid Work Requirements Won't Work for Indian Country
- Medicaid Reform
- Marketplace Cost Sharing Protections
- Tribal Nations Health Briefing
- IHCIA Provisions Chart
- ACA Provisions Summary
Legislative Inquiries:
Caitrin McCarron Shuy, MSc
Government Relations Director
50 F St NW, Suite 600
Washington, DC 20001
Email: cshuy@nihb.org
National Indian Health Board
50 F St NW, Suite 600 | Washington, DC 20001 | Phone: 202-507-4070 | Email: nihbcommunications@nihb.org