Leaders to feds: Keep Medicaid for WR tribesMar 21, 2017 From staff and wire reports
Wyoming is officially on record with the U.S.Congress in asking the federal government to continue to provide 100 percent federal coverage for Medicaid for American Indians.
Gov. Matt Mead signed House Joint Resolution 08 this month, joined by leaders of the Eastern Shoshone and Northern Arapaho tribes.
State Rep. Jim Allen, R-Lander, presented the joint resolution during the legislative session in January.
"Our hope is that Congress listens and heeds this resolution from Wyoming's legislature," said Roy Brown, chairman of the Northern Arapaho Business Council. "This is not just for our tribal people in Wyoming, but for the tribes throughout the United States."
The Federal Medicaid Assistance Percentage reimburses 100 percent of medical services for American Indians.
The resolution was signed before the Trump administration released its new health care bill, which now is being debated in Congress.
For non-American Indians, the state is obligated to match Medicaid payments by 50 percent for Wyoming's low income residents as the law now stands. But because of federal trust responsibilities provided in the U.S. constitution, treaties, court decisions and other federal laws, the federal government pays 100 percent for American Indians under Medicaid rather than requiring the 50 percent match.
Richard Brannan, CEO of the Wind River Family and Community Health Care center in Arapahoe, said keeping 100 percent Medicaid coverage for American Indians is a "win-win for the state" and tribes. He said 100 percent coverage saved the state $4.7 million in 2016 and over the last 10 years has produced an average annual savings to the state of about $3 million.
"One-half of the revenue that we receive to provide health care to families living on the Wind River Reservation comes from Medicaid reimbursements based on the patient services performed," Brannan said. "If the existing Medicaid payment provision is modified or goes away, access to health care will be severely impacted."
In that scenario, they would have to cut 50 percent of staff and services currently provided, he said.
Without Medicaid and other insurance programs, only 40 percent of health care needs are paid by the federal government through the Indian Health Service.
The resolution reaffirms that, even with Medicaid funding, Congress has determined that the current health of the American Indian population is below that of the general population. Local data suggests that in Wyoming, the health disparity results in an average life-span difference of 16 years between American Indians on the reservation and the general population in Wyoming.
Currently Medicaid funding to states is open-ended, so the federal government pays its percentage of whatever the states spend. Under a health care bill now being considered by Congress, the amount of federal Medicaid funding would be capped on a per-person basis. Capping federal contributions to the Medicaid program will likely force states with already tight budgets to limit eligibility and cut benefits to at-risk poor, according to the American Public Health Association.
The Wind River Family and Community Health Care System is operated and managed by the Northern Arapaho Tribe through a Public Law 93.638 contract with the IHS. The contract authorizes the Northern Arapaho Tribe to manage and provide health care services for any enrolled members of federally recognized tribes.