WHEREAS, we, the members of the National Congress of American Indians of the United States, invoking the divine blessing of the Creator upon our efforts and purposes, in order to preserve for ourselves and our descendants the inherent sovereign rights of our Indian nations, rights secured under Indian treaties and agreements with the United States, and all other rights and benefits to which we are entitled under the laws and Constitution of the United States, to enlighten the public toward a better understanding of the Indian people, to preserve Indian cultural values, and otherwise promote the health, safety and welfare of the Indian people, do hereby establish and submit the following resolution; and
WHEREAS, the National Congress of American Indians (NCAI) was established in 1944 and is the oldest and largest national organization of American Indian and Alaska Native tribal governments; and
WHEREAS, state Medicaid programs have historically eliminated optional Medicaid services during difficult budget times in order to balance state budgets despite the fact that when such services are provided to eligible American Indian and Alaska Natives (AI/AN) and delivered by the Indian Health Service (IHS) and tribally operated health programs the eliminated services would have been completely budget neutral to the states since the Federal government reimburses these services at 100% Federal Medical Assistance Percentage (FMAP); and
WHEREAS, many AI/ANs experience severe access to care issues in Medicaid and suffer significantly higher rates of health disparities than most other Americans and providing access to the full range of Medicaid benefits will help to improve the quality of care, prevent chronic health conditions and lower health care costs for AI/ANs served by state Medicaid programs; and
WHEREAS, the State of Arizona has pursued and received approval from the Centers for Medicare & Medicaid Services (CMS) for its 1115 Demonstration Waiver to exempt IHS and tribal health facilities from restrictions in Medicaid benefits and eligibility that had been previously proposed by the State in order to address its budget deficit; and
WHEREAS, the State of Arizona and tribes justified their request to exempt the Indian health system from Medicaid service and benefit reductions was to ensure the continued viability of the IHS and tribal health care delivery system and to address staggering health disparities of Indian people; and
WHEREAS, tribes in other states across Indian Country have experienced similar circumstances as Arizona and requested that State Medicaid agencies pursue similar 1115 Medicaid Waiver amendments to mitigate service and benefit reductions in Medicaid, which will only restrict AI/AN access to care and perpetuate health disparities that have a harmful effect on the health and well-being of AI/AN people; and
WHEREAS, tribes nationally have requested that the states and CMS explore options to exempt American Indian and Alaska Natives from benefit reductions and/or explore opportunities to be able to provide optional services that have already been reduced in the Medicaid program.
NOW THEREFORE BE IT RESOLVED, that the NCAI urges all state Medicaid agencies, the National Association of State Medicaid Directors, the National Governors Association, and the Western Governors’ Association to support preserving and expanding Medicaid services through IHS and tribal health facilities through Medicaid 1115 Demonstration Waivers, or other policy alternatives, when such services are budget neutral to the states; and
BE IT FURTHER RESOLVED, that NCAI urge the Administration and the Centers for Medicare & Medicaid Services to support and approve the efforts of states to exempt IHS and Tribal programs from service and benefit reductions through the 1115 Medicaid Waiver process and to support the collaborations of State Medicaid programs and tribes to move waiver proposals forward to CMS; and
BE IT FINALLY RESOLVED, that this resolution shall be the policy of NCAI until it is withdrawn or modified by subsequent resolution.
CERTIFICATION
The foregoing resolution was adopted by the General Assembly at the 2012 Mid-Year Session of the National Congress of American Indians, held at The Cornhusker Hotel from June 17-20, 2012 in Lincoln, Nebraska, with a quorum present.