Supreme Court Victory: Native Tribes Triumph in Health Care Battle
TL/DR –
The US Supreme Court ruled in favor of Native American tribes in a dispute with the federal government over healthcare costs, requiring the government to cover millions in overhead costs for tribes running their health care programs. The Department of Health and Human Services had argued that it isn’t responsible for the overhead costs associated with billing insurance companies, Medicare, and Medicaid. The ruling means the government could be paying between $800 million and $2 billion per year for all tribes running their healthcare programs.
Supreme Court Sides with Native American Tribes Over Health Care Costs
In a significant shift, the Supreme Court has ruled in favor of Native American tribes in a dispute with the federal government about health care expenses. The 5-4 decision means that the government is obligated to cover millions in overhead costs that tribes incur when running their own health programs.
Covering Costs Essential to Avoid a Funding Gap
Chief Justice John Roberts argued that covering these costs is crucial to prevent a funding deficit and penalizing tribes for pursuing self-determination. The Department of Health and Human Services, however, had disputed its responsibility for the overhead costs associated with billing insurance companies, Medicare, and Medicaid.
Potential Financial Implications of the Ruling
Paying these costs for all self-run tribal health care programs could total between $800 million and $2 billion annually, according to the agency. Justice Brett Kavanaugh expressed concerns in his dissent, joined by Justices Thomas, Alito, and Barrett, arguing that such decisions and tradeoffs should be left to Congress.
Current State of Native American Health Care
The federal Indian Health Service (IHS) has been providing tribal health care since the 1800s under treaty obligations. However, the services are often inadequate and understaffed. Moreover, the average life expectancy among Native American tribal populations is about 65 years, around 11 years less than the U.S. average.
Impact on Tribal Sovereignty and Resources
Adam Unikowsky, who represented the Northern Arapaho Tribe, stated that the decision will promote tribal sovereignty and provide resources for health care in under-served communities.
Contractual Discrepancies and Overhead Costs
The tribes had contracted with IHS to run their own programs, ranging from emergency services to substance-abuse treatment. However, the tribes had to manage the billing themselves, incurring significant overhead costs. This cost the San Carlos Apache Tribe nearly $3 million over three years and the Northern Arapaho Tribe $1.5 million over two years.
Health and Human Services’ Appeal
The Department of Health and Human Services appealed to the Supreme Court, arguing that tribes do receive some funding for overhead costs but aren’t responsible for expenses associated with third-party income. However, the majority of federally recognized tribes now contract with IHS to run at least part of their own health care programming.
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