For the past two years, the Wind River Health Disparities Roundtable has worked on strategies for better healthcare among the Northern Arapaho and Eastern Shoshone. American Indians in Wyoming suffer from an array of health challenges that put life expectancy at 53 years, while the general population has an expected lifespan of nearly 79 years.

Health disparities among minorities result from lower levels of education, which translate to lower incomes and lack of access to transportation, according to Lillian Zuniga of the Wyoming Office of Multicultural Health. On the Wind River Indian Reservation, those factors mean people are less likely to go to health clinics and follow through with medical care.

Meanwhile, those very clinics are starving for revenue. Federal Indian Health Service (IHS) funding accounts for about $12 million of the $23 million in services provided by the clinics in Fort Washakie and Arapahoe last year. Another $11 million in funding comes from collections through private insurance and Medicare/Medicaid reimbursements.

“Without the Medicaid program, the doors on our clinics would not be open, or they would be open only half the time,” Brannan said. “The clinic is funded (by the IHS) at 45 percent of what you need.”

While IHS money pays for salaries for an array of nurses and specialists, it’s Medicaid that buys the 100,000 prescriptions filled by the clinics annually at a cost of $2.8 million, Brannan said. Medicaid also pays for most of the clinics’ primary care doctors.

“Medicaid money, that’s 99 percent of what pays our providers,” said Glen Fowler, health consultant for the Northern Arapaho. “If we don’t have that, we don’t have providers.”