Editor’s Note: U.S. Rep. Michelle Lujan Grisham released the following statement in response to reports that the U.S. Department of Health and Human Services is refusing to consider exempting Tribal governments from state-imposed Medicaid work requirements.
The Trump Administration’s effort to allow Medicaid work requirements to be imposed on Tribal citizens is a direct attack on Tribal sovereignty, and it demonstrates the Trump Administration’s incompetency regarding the relationship between Tribal nations and the federal government. Indian tribes are constitutionally-protected, sovereign entities to which the federal government owes a trust responsibility and whose governmental status has been affirmed repeatedly by the United State Supreme Court since the early 1800’s.
Imposing new Medicaid requirements is an insult to Tribal governments, upends centuries of legal precedent, and ignores the inherent authority of Tribal governments to govern themselves and serve their people.
Imposing new Medicaid requirements is an insult to Tribal governments, upends centuries of legal precedent, and ignores the inherent authority of Tribal governments to govern themselves and serve their people. Further, it disregards the federal government’s obligation to provide quality, accessible health care to Native Americans as well as their mandate to engage in meaningful nation-to-nation consultation.
Native Americans’ unemployment rate is nearly three times the national average and Native Americans suffer some of the worst health outcomes in the nation, including disproportionately high rates of drug overdose, diabetes, and heart disease. Medicaid is a critically important resource for the Indian health system, given that IHS is currently funded at around 50% of need, and average per capita spending for IHS patients is only $3,688 compared with $9,523 nationally. Imposing unworkable restrictions on Medicaid without consultation along with the proposed dramatic cuts to IHS will undoubtedly increase poverty and worsen health outcomes in Indian Country.
By Michelle Lujan Grisham
Michelle Lujan Grisham is a Congresswoman serving New México’s 1st District.