{"id":4728,"date":"2020-11-17T15:05:09","date_gmt":"2020-11-17T21:05:09","guid":{"rendered":"https:\/\/www.indianz.com\/News\/?p=4728"},"modified":"2020-11-17T15:05:09","modified_gmt":"2020-11-17T21:05:09","slug":"cronkite-news-indian-health-care-law-in-hands-of-nations-highest-court","status":"publish","type":"post","link":"https:\/\/indianz.com\/News\/2020\/11\/17\/cronkite-news-indian-health-care-law-in-hands-of-nations-highest-court\/","title":{"rendered":"Cronkite News: Indian health care law in hands of nation&#8217;s highest court"},"content":{"rendered":"<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"500\" data-attachment-id=\"4730\" data-permalink=\"https:\/\/indianz.com\/News\/2020\/11\/17\/cronkite-news-indian-health-care-law-in-hands-of-nations-highest-court\/navajonationcovid\/\" data-orig-file=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/11\/navajonationcovid.jpg\" data-orig-size=\"800,500\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"navajonationcovid\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Native Americans are keeping close watch as the U.S. Supreme Court considers whether to keep, or toss, the Affordable Care Act. The law included permanent reauthorization of the Indian Health Care Improvement Act, and Native leaders worry it could be wiped out. Photo by Daja E. Henry \/ Cronkite News&lt;\/p&gt;\n\" data-large-file=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/11\/navajonationcovid.jpg\" src=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/11\/navajonationcovid.jpg\" alt=\"navajonationcovid\" class=\"alignnone img-fluid wp-image-4730\" \/>\r\n<figcaption class=\"figure-caption\">Native Americans are keeping close watch as the U.S. Supreme Court considers whether to keep, or toss, the Affordable Care Act. The law included permanent reauthorization of the Indian Health Care Improvement Act, and Native leaders worry it could be wiped out. Photo by Daja E. Henry \/ Cronkite News\r\n<\/figcaption>\r\n<div class=\"h3-responsive font-weight-bold\">\u2018Disruptive and cruel\u2019: Native Americans worry as Supreme Court weighs repeal of health care act<\/div>\r\n<div class=\"date\">Tuesday, November 17, 2020<\/div>\r\n<div class=\"byline\">By Jake Lewis and Calah Schlabach<\/div>\r\n<DIV class=source>Cronkite News<\/DIV>\r\n<DIV class=source-website><A \r\nhref=\"https:\/\/cronkitenews.azpbs.org\/\">cronkitenews.azpbs.org<\/A><\/DIV>\r\n<P><\/P>\r\nPHOENIX \u2013 Native American leaders are keeping close watch on the Supreme Court battle over whether to repeal all or parts of the Affordable Care Act, a move many say could devastate health care for American Indians and Alaska Natives.<p><\/p>\r\n\u201cIn our vulnerable populations, particularly in the time of COVID-19 and its disproportionate impact on Native people, this is not where we need to be spending our energy,\u201d said Stacy Bohlen, chief executive officer of the National Indian Health Board.<p><\/p>\r\n\r\nThe Affordable Care Act, signed by President Barack Obama on March 23, 2010, \r\n<a href=\"https:\/\/www.kff.org\/report-section\/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act-how-many-people-are-uninsured\/\">expanded<\/a>\r\nthe number of Americans covered by private or public health insurance.\r\n<p><\/p>\r\n\r\nBut the law, often referred to as Obamacare, also includes a number of provisions specific to Indian Country, including permanent reauthorization of the \r\n<a href=\"https:\/\/www.ihs.gov\/ihcia\/\">Indian Health Care Improvement Act<\/a>, which provides ongoing funding for Native health programs, primarily through the Indian Health Service.\r\n<p><\/p>\r\nIt also expanded tribes\u2019 authority to run their own health care programs, provided for expansion of the IHS and community health care workforce, and included behavioral health and youth suicide prevention programs.<p><\/p>\r\n<blockquote class=\"twitter-tweet\" data-width=\"500\" data-dnt=\"true\"><p lang=\"en\" dir=\"ltr\">TODAY: The U.S. Supreme Court is hearing arguments in a case that could undo the Indian Health Care Improvement Act, affecting programs and services that benefit American Indians and Alaska Natives. Tune in at 10am Eastern.<a href=\"https:\/\/twitter.com\/hashtag\/ACA?src=hash&amp;ref_src=twsrc%5Etfw\">#ACA<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/IHCIA?src=hash&amp;ref_src=twsrc%5Etfw\">#IHCIA<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/IHS?src=hash&amp;ref_src=twsrc%5Etfw\">#IHS<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/SupremeCourt?src=hash&amp;ref_src=twsrc%5Etfw\">#SupremeCourt<\/a> <a href=\"https:\/\/t.co\/qMmtg8D6vd\">https:\/\/t.co\/qMmtg8D6vd<\/a><\/p>&mdash; indianz.com (@indianz) <a href=\"https:\/\/twitter.com\/indianz\/status\/1326175288963833858?ref_src=twsrc%5Etfw\">November 10, 2020<\/a><\/blockquote><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\r\n<P><\/P>\r\n\u201cPeople talk about the Affordable Care Act like it&#8217;s all one thing,\u201d said \r\n<a href=\"https:\/\/healthlaw.org\/the-indian-health-care-improvement-act-another-potential-casualty-of-efforts-to-repeal-the-aca\/\">Sarah Somers<\/a>, an attorney with the National Health Law Program who specializes in litigation to help underserved communities access good health care. \u201cBut really, there&#8217;s almost like five or six different parts of it, and if you repeal it, then all of the codified statutes go away.\r\n<p><\/p>\r\n\u201cIt&#8217;s not to say it (the ACA) is without flaws, but just sweeping it off the table is ridiculous \u2013 and disruptive and cruel to a lot of people.\u201d<p><\/p>\r\nOne of the key, and most controversial, provisions of the law is the so-called individual mandate, which requires most people to be insured or else face a penalty.<p><\/p>\r\nThe U.S. Supreme Court in 2012 upheld the ACA and the individual mandate. But after the election of President Donald Trump, who vowed in his 2016 campaign to repeal the signature achievement of his predecessor, Congress amended the law to erase the financial penalty for not having health insurance, setting it to zero but leaving the mandate on the books.<p><\/p>\r\n\r\nTwenty states, led by Texas, \r\n<a href=\"https:\/\/www.scotusblog.com\/case-files\/cases\/texas-v-california\/\">sued again<\/a>\r\nin 2018, arguing the individual mandate is no longer constitutional because of that change and seeking to have the entire ACA struck down.\r\n<p><\/p>\r\nThe high court heard oral arguments November 10, but a ruling isn\u2019t expected until sometime next year.<p><\/p>\r\n<blockquote class=\"twitter-tweet\" data-width=\"500\" data-dnt=\"true\"><p lang=\"en\" dir=\"ltr\">The fate of the Indian health care system is in the hands of the U.S. Supreme Court in a case where not even the Trump administration is defending the trust and treaty responsibility. <a href=\"https:\/\/twitter.com\/hashtag\/AmyConeyBarrett?src=hash&amp;ref_src=twsrc%5Etfw\">#AmyConeyBarrett<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/SupremeCourt?src=hash&amp;ref_src=twsrc%5Etfw\">#SupremeCourt<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/IHCIA?src=hash&amp;ref_src=twsrc%5Etfw\">#IHCIA<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/ACA?src=hash&amp;ref_src=twsrc%5Etfw\">#ACA<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/NTHC2020?src=hash&amp;ref_src=twsrc%5Etfw\">#NTHC2020<\/a> <a href=\"https:\/\/t.co\/Ukl3lCX81R\">https:\/\/t.co\/Ukl3lCX81R<\/a><\/p>&mdash; indianz.com (@indianz) <a href=\"https:\/\/twitter.com\/indianz\/status\/1317185290629500930?ref_src=twsrc%5Etfw\">October 16, 2020<\/a><\/blockquote><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\r\n<p><\/p>\r\nHundreds of tribes filed a \r\n<a href=\"https:\/\/www.supremecourt.gov\/DocketPDF\/19\/19-840\/143436\/20200513140052379_19-840%2019-1019tsacTribesAndTribalOrganizations.pdf\">brief<\/a>\r\narguing that even if the individual mandate is deemed unconstitutional, the law should not be thrown out entirely and, specifically, that the Native health care provisions should be severed from the rest of the act and protected.\r\n<p><\/p>\r\n\u201cThese Indian-specific provisions are not related to or dependent on the individual mandate specifically or health insurance reform more generally, and they implement a separate and distinct legislative purpose,\u201d the brief states.<p><\/p>\r\nSen. Tom Udall, D-N.M., and vice chairman of the Senate Indian Affairs Committee, said in an email to Cronkite News that the ACA has been \u201cnothing short of lifesaving\u201d for Native communities by expanding access to services, making health care more affordable and helping to create a more dependable system.<p><\/p>\r\nIf the high court overturns the law, he said, \u201cI am deeply concerned that the (Indian Health Service) system will be thrown into chaos, and millions of Native Americans will lose access to lifesaving care during a pandemic that is disproportionately impacting them.\u201d<p><\/p>\r\n<div class=\"mt-1 mb-1\"><ins class=\"adsbygoogle\" style=\"display:block; text-align:center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-8411603009680747\" data-ad-slot=\"6394965691\"><\/ins><script>(adsbygoogle = window.adsbygoogle || []).push({});<\/script><\/div><p><\/p>\r\nMore than 80,000 Native Americans have \r\n<a href=\"https:\/\/www.ihs.gov\/coronavirus\/\">tested positive<\/a>\r\nfor COVID-19, and \r\n<a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/69\/wr\/mm6934e1.htm\">studies<\/a>\r\nshow American Indians and Alaska Natives are three times more likely to contract the disease than white Americans. They also are \r\n<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/covid-data\/investigations-discovery\/hospitalization-death-by-race-ethnicity.html\">more likely<\/a>\r\nto die from the disease.\r\n<p><\/p>\r\n\r\nSuch health \r\n<a href=\"https:\/\/www.ihs.gov\/newsroom\/factsheets\/disparities\/\">disparities<\/a>\r\nare common among Native Americans, whose life expectancy is 5.5 years less than others in the U.S. and who face disproportionately high mortality rates from a host of ailments, including heart disease, liver disease and diabetes. Those underlying conditions also make them more vulnerable to the novel coronavirus that causes COVID-19.\r\n<p><\/p>\r\n\r\nThe Indian Health Care Improvement Act, first passed by Congress in 1976, is part of the foundation for health care in Indian Country. Before the ACA, Congress had \r\n<a href=\"https:\/\/www.nihb.org\/tribalhealthreform\/ihcia-history\/\">struggled<\/a>\r\nfor more than a decade to reauthorize the law.\r\n<p><\/p>\r\nSomers noted the Supreme Court has a few options as justices weigh the ACA: dismiss the challenge, leaving the law intact; find the entire law unconstitutional; or strike down the individual mandate but leave the rest of the law intact, including the Native provisions.<p><\/p>\r\n\r\nDuring oral arguments, several justices seemed to indicate a preference for the last option. Justice Brett Kavanaugh, a Trump nominee to the court, said the case for \r\n<a href=\"https:\/\/www.supremecourt.gov\/oral_arguments\/argument_transcripts\/2020\/19-840_i426.pdf\">excising the mandate<\/a>\r\nbut leaving the rest of the act intact seemed \u201cstraightforward.\u201d\r\n<p><\/p>\r\n\r\nThe death of Justice Ruth Bader Ginsburg, who had voted previously to uphold the ACA, left many questioning the future of the law. Trump nominee Amy Coney Barrett, who was sworn in October 26, has been a \r\n<a href=\"https:\/\/scholarship.law.nd.edu\/cgi\/viewcontent.cgi?article=2330&amp;context=law_faculty_scholarship\">critic<\/a>\r\nof the law.\r\n<p><\/p>\r\n\u201cIt&#8217;s worrisome,\u201d Somers said, referring to how Barrett could alter the outcome of the case. \u201cThere was a lot of publicity about the fact that she was very critical of the decision to uphold the individual mandate.\u201d<p><\/p>\r\nIn Indian Country, Bohlen noted, the ACA further bolstered the health care system by expanding Medicaid coverage for Native Americans.<p><\/p>\r\nA full repeal, she said, \u201cwould take significant numbers of our people off health insurance who never had health insurance before.\u201d<p><\/p>\r\n\u201cIt would cause a total upheaval in our approach to advocacy and education and outreach,\u201d she said.<p><\/p>\r\n\u201cIn the context of what we&#8217;re all facing \u2026 this is not the time to add this extra burden and an additional crisis onto the Indian health system and onto Indian people.\u201d<p><\/p>\r\n<STRONG>For more stories from Cronkite News, visit <A href=\"https:\/\/cronkitenews.azpbs.org\/?utm_source=referral&amp;utm_medium=referral&amp;utm_campaign=client\">cronkitenews.azpbs.org<\/A>.<\/STRONG>\r\n<p><\/p>\r\n<HR><EM>Note: This story originally <a href=\"https:\/\/cronkitenews.azpbs.org\/2020\/11\/16\/indian-country-waits-supreme-court-considers-health-care-act\/\">appeared on Cronkite News<\/a>.  It  is published via a <A href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/\">Creative  Commons license<\/A>. Cronkite News is produced by the <A href=\"https:\/\/cronkite.asu.edu\/\">Walter Cronkite School of Journalism and Mass Communication<\/A> at <A href=\"https:\/\/www.asu.edu\">Arizona State University<\/A>.<\/EM><HR>","protected":false},"excerpt":{"rendered":"Native leaders are keeping close watch on the Supreme Court battle over whether to repeal all or parts of the Affordable Care Act, a move many say could devastate health care in Indian Country.","protected":false},"author":1,"featured_media":4730,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"_vp_format_video_url":"","_vp_image_focal_point":[],"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[19,20,13,1,14],"tags":[385,390,42,828,5,46,506,210,368,213,91,372,84,301],"class_list":["post-4728","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-indian-trust","category-law","category-national","category-politics","tag-aca","tag-amy-coney-barrett","tag-arizona","tag-brett-kavanaugh","tag-coronavirus","tag-cronkite-news","tag-ihcia","tag-ihs","tag-nihb","tag-scia","tag-senate","tag-stacy-bohlen","tag-supreme-court","tag-tom-udall","no-wpautop"],"jetpack_featured_media_url":"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/11\/navajonationcovid.jpg","jetpack_shortlink":"https:\/\/wp.me\/pcoJ7g-1eg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/posts\/4728","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/comments?post=4728"}],"version-history":[{"count":0,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/posts\/4728\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/media\/4730"}],"wp:attachment":[{"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/media?parent=4728"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/categories?post=4728"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/tags?post=4728"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}