Native Americans are exempt from the health law’s requirement to have insurance coverage. That’s because they’re eligible for health care through the Indian Health Service, or IHS, since the federal government promised in treaties to provide health care in exchange for tribes giving up their land. How’s the IHS doing?

Montana Senator Jon Tester, who sits on both the Veterans and Indian Affairs committees, puts it this way:

"The VA is actually in better shape than the Indian Health Service. It is really in tough shape, it basically runs out of money about nine months into the fiscal year, I mean, it’s really in crisis."

The IHS budget crisis means tribal members can often only get health care when they’re in immediate danger of losing life or limb, says Lesa Evers a Blackfeet descendent and member of the Turtle Mountain tribe who works for Montana’s state health department.