Dr. Ruiz, Sen. Harris Lead Fight for Tribal Health Funding in Next COVID-19 Relief Legislation
Washington, DC – Congressman Raul Ruiz, M.D. led a letter signed by 47 bipartisan members of the House calling for Speaker Nancy Pelosi (D-CA) and Minority Leader Kevin McCarthy (R-CA) to include dedicated funding for Indian Health Service, Tribal health programs, and Urban Indian Health Organizations (I/T/U) to recover from significant COVID-19 related losses in revenue in the next stimulus legislation.
"Tribal health facilities are the primary source of health care for millions of native American individuals, and many are struggling to keep their doors open during this crisis," said Dr. Ruiz. "Native communities often have greater health disparities than other populations, and it is essential that Congress provides a significant emergency relief fund to support tribal health programs."
"The National Indian Health Board urges lawmakers to include direct financial relief for Indian Health Service and Tribal health facilities in the next congressional response package to help replenish shortfalls in third party reimbursement dollars due to the COVID-19 pandemic. Third party reimbursements from payers like Medicare, Medicaid, and private insurance are integral to the fiscal stability of the Indian health system. Similar to federal, state and private healthcare systems, Tribes are utilizing every resource to protect their citizens from COVID-19 including issuing stay-at-home orders, cancelling non-emergency medical procedures, and reducing in-person health clinic visits. Unfortunately, those precautions are resulting in millions of lost third-party revenue that pay for essential health services from elder care to dental care to diabetes treatment. NIHB commends Congressmen Ruiz and Congressman Mullin for urging their colleagues to support third party reimbursement relief funding for the Indian health system," said NIHB Chairperson Victoria Kitcheyan and Tribal Councilmember for the Winnebago Tribe of Nebraska.
"Third-party reimbursements are vital to Urban Indian Organizations (UIOs) and to the Indian health system as a whole. This is a matter of keeping facilities open for the patients and families who need them during this pandemic. Unfortunately, the COVID-19 pandemic is upending this system. UIOs are experiencing millions in lost third-party reimbursement as a result of impacts from COVID-19. We are grateful for this bipartisan bill to help the Indian Health Care Providers who are operating on the front lines of this pandemic," said Francys Crevier, NCUIH, Executive Director.
Dr. Ruiz's letter advocates for a dedicated emergency appropriation to help tribal health facilities recover from lost revenue as a result of the COVID-19 pandemic. Because most non-essential and elective procedures have been cancelled in order to comply with public health measures, tribal health facilities are not collecting revenue from third-party reimbursements for provided care.
Third party reimbursements can account for more than 50% of the operating budgets for tribal health programs. In 2019 alone, federally operated IHS facilities collected over $1 billion in third party reimbursements.
You can read a copy of the letter here.
Background
The Riverside-San Bernardino Indian Health Organization is a consortium made up of nine local tribes and provides services for tribal members in the region. Several of their facilities are operating with reduced schedules during COVID-19.
Partner tribes include the Agua Caliente Band of Cahuilla Indians, the Pechanga Band of Luiseno Mission Indians, the Ramona Band of Cahuilla Indians, the Cahuilla Band of Indians, the Soboba Band of Luiseno Indians, the Morongo Band of Mission Indians, the Santa Rose Band of Cahuilla Indians, the San Manuel Band of Mission Indians, and the Torres-Martinez Desert Cahuilla Indians,
H.R. 748, the CARES Act, allocated $100 billion to support hospitals that are struggling from losses in revenue, but did not include a set-aside specifically for the tribal health care system. On April 22nd, the Department of Health and Human Services announced they would allocate $400 million from this fund to the Indian Health Service. While this is important, it will not be sufficient to cover the losses. The National Indian Health Board estimated that tribal health facilities will require as much as $1.7 billion to make up for lost revenue since mid-March.
The letter was signed by the Co-Chairs of the Native American Caucus, Deb Haaland & Tom Cole, as well as the Chairs of the two Congressional Subcommittees who oversee the Indian Health Service, Anna Eshoo (Energy and Commerce Health Subcommittee) and Betty McCollum (Appropriations Interior and Environment Subcommittee).
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