Washington Report

An NIHB Publication

The Washington Report is an e-newsletter produced by the National Indian Health Board. Each issue contains a listing of current events on Capitol Hill, information on passed and upcoming legislation, Indian health policy analysis and action items.

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Health Care Reform in the 115th Congress

Congress is considering major changes to the Affordable Care Act that will revolutionize the American healthcare system. The legislation – known as the American Health Care Act (AHCA) – passed the U.S. House of Representatives on May 4, 2017 and is being considered by the full Senate. The legislative language contained in this resulting bill calls for significant changes to the health insurance markets, health insurance subsidies, penalties and the Medicaid program. The AHCA proposes Medicaid per capita caps, shortens enrollment periods into health care insurance, and implementation of a series of age-based tax credits for securing coverage; a great departure from models seen under the ACA. Tribes have many reasons to be concerned.

In response to the AHCA proposal, the National Indian Health Board (NIHB) and National Congress of American Indians (NCAI) issued a joint letter to Majority Speaker of the House, Paul Ryan, outlining several priorities for Tribal communities. These include:

  • Preserve Medicaid Expansion for all Americans and especially for individuals receiving Medicaid through an Indian Health Service (IHS) or Tribally operated health facility
  • Clarify that AI/ANs should not be subject to state-imposed work requirements under the Medicaid program
  • Continue the cost sharing protections for AI/ANs contained in section 1402(d) of the Affordable Care Act

Fortunately, it currently looks like there is no effort underway to undermine the Indian Health Care Improvement Act or other Indian-specific provisions in the ACA. NIHB is working to ensure that the progress made by the permanent enactment of the IHCIA and other provisions of ACA is retained. This includes preserving Medicaid benefits for American Indians and Alaska Natives and other special protections and benefits. Please use the following resources to help us advocate for Tribal health priorities on Capitol Hill. All documents are PDFs unless otherwise noted.

Senate Legislation (BCRA)

House Legislation (AHCA)

Tribal Priorities

Background Materials



Legislative Inquiries:

Caitrin Shuy
Director, Congressional Relations

910 Pennsylvania Ave, SE
Washington, DC 20003
Phone: 202-507-4085
Email: [email protected]