Policy Briefs

Tribal Sovereignty and Medicaid Work Requirements for American Indians and Alaska Natives
Tribal Sovereignty and Medicaid Work Requirements for American Indians and Alaska Natives
Updated: May 17, 2018

The Seattle Indian Health Board (SIHB) strongly objects to the Centers for Medicare and Medicaid Services’ (CMS) recent actions and statements regarding the imposition of work requirements and other restrictive conditions on Medicaid eligibility for American Indians and Alaska Natives (AI/AN). CMS’s position that tribes are not eligible for exemptions to these Medicaid work requirements runs contrary to long-settled issues of Constitutional law and Congressional intent. In order to carry out the federal government's Trust Responsibility to AI/AN, CMS is obligated to exempt AI/AN people from these community engagement requirements.

Tribal Sovereignty and Legal Protections for American Indians and Alaska Natives
Tribal Sovereignty and Legal Protections for American Indians and Alaska Natives
Updated: April 30, 2018

The Seattle Indian Health Board is alarmed by the Trump administration’s recent efforts to roll back decades of hard-fought protections for American Indian and Alaska Native people by re-classifying AI/ANs as members of a racial group, rather than as enrolled members of sovereign governments. The administration’s view is that AI/AN people cannot receive "different" treatment under federal law because this would raise constitutional and federal civil rights concerns. But this view is completely at odds with the federal Constitution and with hundreds of years of statutes and jurisprudence.

Legislative Update - Community Health Center Fiscal Cliff
Legislative Update - Community Health Center Fiscal Cliff
Updated: December 13, 2017

Funding for the Community Health Center Fund expired on October 1, 2017. Without action by Congress, health programs within the IHS, Tribal 638, and Urban Indian Health Program system of care could face a 70% cut in Community Health Center grant funds creating unprecedented challenges to providing care to our American Indian and Alaska Native community. (Dec 2017)

Policy Brief: 100% FMAP for Urban American Indians and Alaska Natives
Policy Brief: 100% FMAP for Urban American Indians and Alaska Natives
Updated: March 28, 2017

Urban Indian Health Programs (UIHP) are currently attempting to gain eligibility for Medicaid’s 100% Federal Medical Assistance Percentage (FMAP) payment for their IHS eligible patients receiving services at UIHPs. Confusion about 100% FMAP exists due to the complexity of the administration of 100% FMAP and constraints around the methods available to add UIHPs as qualifying facilities eligible for 100% FMAP. This policy brief serves to clarify the facts and to challenge some misconceptions about 100% FMAP eligibility for UIHPs. (March 2017)

Political Shifts Impacting the Affordable Care Act
Political Shifts Impacting the Affordable Care Act
Updated: December 22, 2016

President-elect Donald Trump, House Speaker Paul Ryan, and Representative Tom Price, MD each have health insurance approaches that will present challenges to the IHS, Tribal, and Urban Indian health services (I/T/U) system. This policy brief examines the possible impacts of the upcoming political shifts on the Affordable Care Act and the I/U/T system. (December 2016)

Policy Brief: The Need for Urban AI/AN Voice & Opportunity
Policy Brief: The Need for Urban AI/AN Voice & Opportunity
Updated: December 22, 2016

Because urban AI/ANs dwell outside the areas where federally recognized tribes have jurisdiction, they are left voiceless in informing policy created for the wellbeing of the entire AI/AN population. This brief discusses the need for urban AI/AN voices in health policy, the Indian Health Care Improvement Act, and possible upcoming legislative changes. (December 2016)