Heinrich: Medicaid Work Requirements For Native Americans Not A State Issue, Tribal Sovereignty Is Clearly A Federal Responsibility

U.S. Sen. Martin Heinrich


WASHINGTON, D.C. – U.S. Sen. Martin Heinrich (D-N.M.) is urging the U.S. Department of Health and Human Services (HHS) to reconsider its proposal to leave the decision to exempt American Indians and Alaskan Natives from work requirements for Medicaid up to the states.

“Tribal sovereignty is clearly a federal responsibility and not an issue to be delegated to the states. This misguided proposal will go directly against the federal government’s responsibility to provide health care for our Native population and to honor the government-to-government relationship that is embedded in the Constitution, ratified by numerous treaties, reaffirmed by the Supreme Court, and codified by federal law,” Heinrich wrote in a letter to HHS Secretary Alex Azar.

Heinrich asked that any attempt to make changes that would affect healthcare for Native Americans involve meaningful consultation with Tribal leaders, and that their feedback be adequately taken into account for any future policy proposals.

“Native American populations are some of the most vulnerable populations within Medicaid. They are often in economically disadvantaged areas that lack proper access to needed services. Enacting work requirements would do nothing to improve health outcomes in Indian Country and would mark another betrayal by violating the sacred commitment we strive to fulfill as representatives of the federal government,” Heinrich continued.

Indian country relies on Medicaid as a critical source of healthcare. In New Mexico, the Indian Health Service (HIS) serves approximately 200,000 patients in areas where Native American unemployment exceeds 16 percent. Implementing work requirements for a population which experiences persistently high unemployment rates could be potentially catastrophic. Further, these detrimental changes will strip the IHS and other facilities of an important funding source. Implementing work requirements for Indian country could result in the loss of millions of dollars to communities facing chronic health care access challenges.

A copy of the letter is available here.


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