The Colorado River Indian Tribes’ Office of the Chairman issued a brief statement last week in response to the Trump Administration’s claim that Tribal members should be required to work or be looking for work before they can receive Medicaid assistance.
Three states, Kentucky, Indiana and Arkansas, have begun implementing new rules that require residents to work or be looking for work in order to qualify for Medicaid. While the courts have viewed tribal members as a political class and their governments as sovereign, the Administration contends they are a race and should not be exempt from state regulations.
Politico stated on April 22 this is a challenge to the longtime historical standing of tribal governments.
In the statement that appeared on the Manataba Messenger Facebook page April 22, the Office of the Chairman reminds Tribal members of the various treaties and promises made to native peoples by the U.S. Government:
“What promises did the United States make in the treaties?
In return for the vast Indian holdings and resources, the United States made certain promises:
Protection for Indians from attacks upon their lands (this protection included legal assistance).
Sovereignty and religious freedom.
Confirmation and protection of certain rights: self-government, fishing and hunting rights, and jurisdiction over their own lands.”
Mark Trahant, the editor of Indian Country Today, told High Country News that Medicaid represents 13 percent of Indian Health Services’ annual $6.1 billion budget. Many states rely on Medicaid to provide health care to underserved areas. As an example, he said Alaska spends 40 percent of its $1.8 billion Medicaid budget on Alaska Native patients.
Trahant said adding work requirements means fewer people will sign up for Medicaid and Indian Health Services will have to pick up the extra costs. This will mean fewer health services across the board.
Politico reported the unemployment rate among Native Americans is 12 percent, or three times the national average. This is largely due to a lack of employment opportunities on reservations. Tribal members also suffer from high rates of poverty, substance abuse and chronic diseases.
Politico also said any claims of racial preference are moot because tribal governments are constitutionally protected as separate governments. This goes back to the time of George Washington and has been reaffirmed under Democratic and Republican Presidents alike.
“The United States has a legal responsibility to provide health care to Native Americans,” Mary Smith told Politico. She was acting head of the Indian Health Service during the Obama administration and is a member of the Cherokee Nation. She went on to say, “It’s the largest prepaid health system in the world — they’ve paid through land and massacres — and now you’re going to take away health care and add a work requirement?”
Graham Lee Brewer of High Country News, who is a member of the Cherokee nation, said the Administration’s assertion that tribal nations are a racial distinction and not a political classification highlights President Donald Trump's lack of understanding of tribal sovereignty.
“The President has no interest in understanding Indian Country,” Brewer said.