Closing the Gap in Indian Country
Fifty years ago this week Medicaid and Medicare were signed into law. These two programs provide children, seniors, people living with disabilities and working families with access to the health care they need. To celebrate 50 years of these two programs, each day this week one of our partners will share a story about their work to ensure more people can access Medicaid. We’ll also be reflecting on the two programs and what’s ahead.
Hannah is a 27-year-old member of the Confederated Salish and Kootenai Tribes in northwest Montana. She works as a massage therapist and research assistant, and is also a caregiver for her elderly grandmother and quadriplegic cousin. Two years ago, Hannah was diagnosed with Lyme disease and recently her health has declined drastically.
Right now, Hannah is uninsured. She can’t afford health insurance and doesn’t make enough to qualify for tax credits. She’s able to access basic health care through Indian Health Services (IHS), but is unable to get the specialist care she needs to manage her Lyme disease. She had to pay $900 out of pocket for lab work just to get a definitive diagnosis.
“Having expenses for medical care is really hard for my family,” Hannah said. “Medicaid would give me the chance to see a doctor where I live and live a healthy, normal life.”
Hannah is just one of approximately 20,000 American Indians in Montana who will benefit from closing the coverage gap by expanding access to Medicaid. Montana ranks highest of any state in uninsured American Indians (40 percent) and the second lowest in number of American Indians with private insurance (28 percent). IHS faces an ongoing and severe funding shortage, with federal funding covering only 60 percent of the demand for care. Many American Indians who rely on IHS for care experience a lack of access to specialty care, like Hannah, preventative care, or early treatment for chronic disease. Medicaid plays a very important role in bridging the gap in access to care.
Current Medicaid recipients in Indian Country are able to seek care from IHS-run tribal or urban Indian clinics, as well as other non-tribal health care facilities. In addition to better health outcomes and continuity of care, Medicaid provides an influx of federal dollars that creates an economic boost to IHS and communities in Indian Country. This federal funding can increase the capacity of IHS to meet the health care needs of the community, improve their core services, and update equipment and facilities.
Services provided by IHS to American Indian Medicaid recipients are 100 percent reimbursable by the federal government, and this reimbursement rate will not change when the coverage gap closes. Not only do Medicaid recipients get better access to health care, and not only does IHS receive a much needed influx of funds, but there is no fiscal obligation to the state.
For years, Medicaid has helped to create strong and healthy individuals, families, and communities in Indian Country. As we celebrate Medicaid’s 50th anniversary, we should celebrate the positive impact Medicaid has on reservations and in urban Indian communities, and we should also remember that we have a unique opportunity to continue to improve health care and support communities in Indian Country through Medicaid expansion. For Indian Country, closing the coverage gap is one step toward eradicating generations of extreme health disparities affecting American Indians. Most of all, it is a commitment that will strengthen Montana’s families, communities, and economy.
Sarah Howell, Executive Director, Montana Women Vote