Native Americans may lack access to health insurance in Montana

Report highlights the disparity in insurance access among Native communities

By S. Vagus, Live Insurance News

A new report from the Alliance for a Just Society, Indian People’s Action, and the Montana Organizing Project suggests that Native Americans may not have as much access to Montana’s health insurance exchange as they should. Approximately 6.5% of Montana’s population is comprised of Native Americans, with an estimated 1.7% of enrollees in the state’s health insurance exchange falling into this demographic. The report highlights barriers that exist in the state that may be preventing Native Americans from receiving medical care.

There are significant barriers blocking Native Americans from the coverage that they need

The report notes that access to insurance coverage does not guarantee quality medical care. According to the report, the delay in expanding the state’s Medicaid program has prevented many people from receiving the care that they need, as a significant portion of consumers cannot afford coverage offered through the state’s health insurance exchange. The report also notes that there has been a significant lack in outreach to Native American consumers, which means that these consumers are not being made aware of the services offered by the state’s insurance exchange.

Efforts are underway to improve access to health insurance

In the earliest days of the state’s insurance exchange, Native American organizations were not provided with grants from the federal government that would pay for insurance navigators. These navigators are meant to assist consumers in enrolling for health insurance coverage through a state exchange. The navigators also provide information concerning the provisions of the Affordable Care Act and can provide some insight on the availability of subsidies being offered by the federal government. Without navigators, Native communities were unable to access the information that these navigators were meant to provide. Now, however, certified application councilors are available to take on the role of navigators.

Expanded Medicaid system may be helpful

Montana is still planning to expand its Medicaid system, but this could take time. Implementing the expansion may ensure that more Native peoples have access to health insurance coverage, but outreach efforts will have to increase if the state wants to ensure that these people are even aware of the expansion. Without outreach, many Native consumers may not know that they are becoming eligible for health insurance through Medicaid.

Grant money to advance Native American cancer study

An educational partnership aims not only to fight the disease among the Native American population, but to engage more students of native descent

By Charly Edsity, 12 News & The Arizona Republic

There isn’t a word for cancer in most indigenous languages, yet it affects Native Americans at an abnormally high rate.

The Partnership for Native American Cancer Prevention (NACP), a joint effort between Northern Arizona University and the University of Arizona Cancer Center, is the recipient of a $13 million grant from the National Cancer Institute, that will be split between the both universities.

“People die of cancer in Native American populations higher than other groups,” said Jani Ingram, associate professor of chemistry and biochemistry at NAU and member of the Navajo Nation.

According to the Intercultural Cancer Council, cancer is the third-leading cause of death among Native Americans, but there is no conclusive evidence to determine why.

Since 2002, NACP has worked to understand the reason cancer affects Native Americans, specifically tribes in the Southwest, at higher rates and seeks to engage Native American college students in entering science fields to help further research.

NAU’s program has 10 student researchers working under Ingram, some whom have been personally impacted by the deadly disease.

“It started with my grandfather, who worked in uranium mines and he died from lung cancer,” said NAU senior Erik Peaches, who is of Navajo descent.

Erik Peaches, NAU senior, works in lab as part of the Native American Cancer Prevention project at NAU.(Photo: 12 News)
Erik Peaches, NAU senior, works in lab as part of the Native American Cancer Prevention project at NAU.(Photo: 12 News)

In recent years, cancer spikes among older Navajos have been attributed to uranium exposure, a mining industry that boomed on the Navajo Reservation during the 1950s. The radioactive element still threatens communities surrounding abandoned mines and even contaminates drinking water.

NAU senior Ethan Paddock’s grandmother battled breast cancer that he says was caused by uranium exposure on the Navajo Nation.

“My family is from Cameron (Ariz.) and I know there is a huge uranium deposit over there,” Paddock said. “And it’s actually affected my grandmother and (she) got breast cancer.”

After a round of chemotherapy, Paddock’s grandmother has been declared cancer-free, but most with the disease don’t have the same outcome.

The grant money will continue the research being conducted in the Hopi, Navajo and Tohono O’odham communities, work that Ingram said more Native American students should consider.

“If it is a native student, a Navajo student, a Hopi student working on an issue that’s really important to their community, the passion is just right there,” Ingram said.

Remote Tribe Wins Some EMS Funding

By Mike Heuer, Courthouse News Service

(CN) – The Pyramid Lake Paiute Tribe in remote northwestern Nevada won partial federal funding for its emergency medical services program serving the Fort McDermitt Tribe.
U.S. District Judge Christopher R. Cooper on Tuesday partially granted the tribe’s motion for summary judgment in its complaint against the Secretary of Health and Human Services and the Indian Health Services, which denied it funding this year.
The Fort McDermitt Paiute and Shoshone tribes, collectively called the Fort McDermitt Tribe, live in a small, remote community along the Nevada-Oregon border, where Indian Health Services (IHS) has operated a tribal health clinic since the 1970s. The clinic provides primary medical, dental and mental health care and drug and alcohol treatment programs.
The IHS has provided emergency medical services for the tribe since 1993, but the program’s costs increased greatly after a 2010 IRS rule requiring contract workers to be classified as employees, Judge Cooper Found. In 2012, the EMS incurred $502,611 in costs against $102,711 in revenue. The difference was paid through clinic revenue and IHS discretionary funds.
The Fort McDermitt Tribe last year designated the Pyramid Lake Tribe as its tribal organization in accordance with the Indian Self Determination and Education Assistance Act. Cooper says the Pyramid Lake Tribe requested $502,611 plus another $196,739 for startup costs and $136,139 for contract support costs from the IHS.
Previously, the Fort McDermitt Tribe designated Humboldt General Hospital as its base hospital for emergency medical services, but Cooper says the hospital in August 2013 notified the IHS it no longer would be the tribe’s base hospital.
“The agency explained that IHS had ‘ceased operation of the Fort McDermitt emergency medical services program’ due to its large operating deficit. Because IHS had discontinued the program, it reasoned that the base amount available for contracting was zero,” Cooper wrote in his 15-page opinion. “It therefore declined the tribe’s proposal as being ‘in excess of the applicable funding amount.'”
The Pyramid Lake Tribe responded by suing the IHS and Health and Human Services “seeking to require IHS to enter into a self-determination contract with the tribe to operate the Fort McDermitt emergency medical services program.”
Both sides sought summary judgment. HHS Secretary Sylvia Burwell also sought dismissal, “for failure to join indispensable parties, namely, other area tribes whose funding may be affected by the outcome of the case.”
Cooper held a hearing on the motions on Aug. 28.
Summing it up, Cooper wrote that Burwell “argues that because the tribe’s proposal implicates the budget for other tribes served by IHS in the region, each of these tribes is a necessary party to this action. She reasons further that because the other tribes are protected by sovereign immunity, they cannot be joined and the case therefore must be dismissed.”
After citing four other cases in Native American law, Cooper says: “The Secretary’s position is that the Pyramid Lake Tribe’s proposal would unfairly benefit the Fort McDermitt Tribe by enabling it to receive more than its share of funding, to the detriment of neighboring tribes.”
The judge says Burwell “argues in her motion for summary judgment that IHS calculates funding for programs based on the ‘tribal share’ that supports the programs that are to be transferred to the tribe” and “contends that the funding level in the Tribe’s proposal was in excess of the tribal share IHS determined the Fort McDermitt Tribe was entitled to receive.”
Burwell claims that share amount came to just $38,746, according to Cooper’s analysis. The judge added that Burwell “argues even if the emergency medical services program remained in existence,” the Pyramid Lake Tribe’s proposal exceeded that sum.
However, “IHS never advanced this tribal share argument in declining the tribe’s proposal,” Cooper found. “It cannot now be used as a post-hoc to justification for the agency’s decision.”
In denying Burwell’s motions and partially granting the tribe’s, Cooper says that while “the court will issue an order declaring that the Secretary violated the ISDEAA by denying the tribe’s proposal outright, it will not direct her to enter into the tribe’s contract at the 2012 amount.”
“Rather, it will direct the Secretary to negotiate with the tribe over what the Secretary ‘would have otherwise provided’ for the emergency medical services program had IHS continued to operate it, plus the administrative and startup cost.”