Snoqualmie Indian Tribe

Myth: Alaska Native and American Indian people receive free health care.

Fact: Pre-paid health care and other services were purchased from the U.S. government through numerous treaties and legislation.

Myth: Alaska Native and American Indian people receive government health care because of the actions of people hundreds of years ago.

Fact: Alaska Native and American Indian health care is based on many factors, including land deals as recent as the 1970's.

What many people do not understand is that Alaska Native and American Indian people have paid for their health services in full. In essence, the health care for indigenous peoples in the United States has been “prepaid” by agreements related to land and resources. Alaska Native and American Indian communities have purchased services from the federal government through government to government agreements with the United States, captured in numerous treaties and legislation. The Indian Health Service (IHS) oversees these services. The contractual relationship, established in 1787, is based on Article I, Section 8 of the U.S. Constitution. For some 200 years, the federal government has acknowledged treaties by passing legislation and providing funding. One of the latest pieces of legislation is the Indian Health Care Reauthorization Act, which has been stalled in Congress for nearly a decade. The Senate recently passed the bill, which President Bush has threatened to veto. The bill needs approval from the House of Representatives before becoming law. The land acquired by the United States in these deals continues to yield immeasurable value to the American people. Some of that land is still owned and managed by the U.S. government, and is used for Americans’ business pursuits, such as logging and mining, and for recreation. Americans have used the land for mining and farming, as well as paving and building on it the thousands of towns and cities, and millions of homes, where Americans live and work. In return for this land, IHS serves as the principal federal health care provider and health advocate for Alaska Native and American Indian people, with a goal to raise their health status to the highest possible level. IHS currently provides health services to approximately 1.5 million Alaska Native and American Indian people who belong to more than 557 federally recognized tribes in 35 states. Tribes may also choose to take specific program shares or to become totally self-governing. Self-Governance Tribes have total control over all of their health-related programs. Alaska tribes took over all contractible functions from the IHS, including health care delivery for the Alaska Native people, making Alaska the first state to do so. By its own calculations, the U.S. government falls massively short of providing funding for the provision of basic health services for Alaska Native and American Indian Communities. The government provides only 40 percent of what would be considered adequate funding. Senate Majority Leader Harry Reid made a statement on the floor of the U.S. Senate in February: “Right now, our Native American communities have access to some of the least adequate health care in America. Far too many Native children are diagnosed with diabetes, suffer from abuse and neglect, or die prematurely because of accidents or illness that could be prevented or cured. Far too many adults get lost in a sea of bureaucracy and fail to receive the preventive care and other health benefits they need and deserve.” The reauthorization of the Indian Health Care Improvement Act passed in the U.S. Senate on Feb. 26, and now awaits the consideration of the U.S. House of Representatives. Once fully enacted into law, this bill would address some of the inadequacies of the current funding. “Millions of our first Americans await our action,” said Reid. “Let’s quickly pass this bill and send it to the President for his signature. Let’s let our country’s Native Americans know that they are not forgotten, and that we will deliver them the care that they deserve.”

(Taken in part from South Central Foundation May 1, 2008)