Resolution 2018-18: Obtain Full Health Funding and Protect Medicaid Funding for the Alaska Tribal Health System

WHEREAS, the United States has a federal trust relationship to Alaska Natives and Alaska Natives tribes based in the US Constitution and reaffirmed in federal statutes including the Snyder Act of 1921, the Indian Self-Determination Act, the Indian Health Care Improvement Act, and the Indian Child Welfare Act; and

WHEREAS, services made available to Alaska Natives because of our political status as Alaska Natives is a direct consequence of this federal trust responsibility in which the United States has a legal, moral and ethical duty to promote the health and welfare of Native people; and

WHEREAS, in recognition of the United States trust responsibility to provide tribal health care, Congress created the Indian Health Service and tasked the agency with providing health services to tribes across the country; and

WHEREAS, each year, a tribal workgroup and the IHS work diligently to synthesize the priorities identified by Tribes in each of health care delivery Service Areas, including Alaska, into a cohesive message outlining Tribal funding priorities nationally; and

WHEREAS, full funding for services to Native people would be over $32 billion annually, today, IHS is only funded at $5.2 billion. Tribal people will not overcome the significant health disparities with blatantly underfunded programs; and

WHEREAS, Congress amended the Social Security Act over 40 years ago in 1976 to authorize Medicare and Medicaid reimbursement for services provided in IHS and tribally operated health care facilities in part to reduce the shortfall of health funding for Native people. This act recognized that the trust responsibility for health extends to the entire federal government, not just Indian Health Service; and

WHEREAS, 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.

NOW THEREFORE BE IT RESOLVED that the Tanana Chiefs Conference Full Board of Directors seek full funding for Health services to American Indians and the Alaska Native Tribal Health system; and

BE IT FURTHER RESOLVED that if major reforms occur to the American health care system, TCC seeks to:

  1. Maintain Medicaid funding based on need, rather than capping it according to a complicated per capita allocation formula or through capped block grants; and
  2. Continue Medicaid Expansion, and at the very least, continue Medicaid Expansion for American Indians and Alaska Natives; and
  3. Protect American Indians and Alaska Natives from barriers to care that are inconsistent with the federal trust responsibility, such as work requirements under Medicaid; and
  4. Retain cost-sharing protections at Section 1402 of the Patient Protection and Affordable Care Act (ACA); and
  5. Maintain funding for preventative services, including the Prevention and Public Health Fund and women’s health services.

Submitted by: Tok Native Association


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