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


NIHB Board Members Deliver Remarks to Members of the Senate Committee on Indian Affairs about Tribal Health Reform Priorities

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. The Senate failed to pass its version of the legislation – the Better Care Reconciliation Act –in July 2017.

The policies outlined in this proposal called for significant changes to the health insurance markets, health insurance subsidies, penalties and the Medicaid program. The proposed Medicaid per capita caps, shortened 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.NIHB and other Tribal organizations sent letters to Congress outlining the Tribal priorities for health reform:

  1. Maintain Medicaid funding based on need, rather than capping it according to a complicated per capita allocation formula or through capped block grants.
  2. Continue Medicaid Expansion, and at the very least, continue Medicaid Expansion for AI/ANs
  3. Protect AI/ANs from barriers to care that are inconsistent with the federal trust responsibility, such as work requirements under Medicaid
  4. Retain cost-sharing protections at Section 1402 of the Patient Protection and Affordable Care Act (ACA); and
  5. Maintain funding for preventative services, including the Prevention and Public Health Fund and women’s health services.

Though the legislation is not being considered at the moment, it is still important for Indian Country to remain vigilant about these proposals. 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]