American Indians/Alaska Native Health Case Study

Introduction

“Health characterized by Ralph Waldo Emerson is the, “complete mental, social, and physical well-being, and not just the absence of disease or infirmity.” American Indians/Alaska Natives (AI/AN) are a diverse group of people who have overcome a lot to get to where they are today. According to the U.S. Census Bureau in 2013, “there were roughly 5.2 million American Indians and Alaska Natives living in the US” (“American Indian & ANP”). American Indians/Alaska Natives have a unique relationship with the federal government due to historic conflict and following treaties (“American Indian & ANP”). Tribes do in fact exist as “foreign entities” or outside of the US government; however, federally they are entitled to health and educational

Also, that measuring the quality of health care for is challenging due to the diversity of the population and its potential sources of health care. In studying these factors, it is also important to note the present conditions of health care currently for American Indians/ Alaska Natives. Presently, the Indian Health Services provide health care and disease prevention to approximately 2.2 million AI/ AN with a total of $US 4.3 billion appropriated for IHS in 2013 (Artiga). These numbers have expanded exponentially since then with a projected 6 billion dollars to be spent on HIS over the next 4 years ("FY2015 Budget in Brief - IHS"). The Indian Heath Services also rely on revenue from third party payers including Medicare, Medicaid and other private insurances (Artgiga). By far the largest third party payer is Medicaid which account for 70% of TPP and 25% of IHS revenue as of 2013

There is sufficient evidence that supports the lack of adequate health care for this population, and I believe a considerable effort is trying to address it. President Obama and his administration have worked very hard to pass the Affordable Health Care Act and allow for the appropriate provisions after its passing. In the provision of the Health Care Act, the federal government covers 100% of a state’s cost for services provided to AI/AN through the Indian Health Services or tribally operated facilities (Artiga). I believe this is a substantial amount, and if that weren’t enough the expansion of the Federal Poverty Level of FPL now covers 9 out of 10 incomes in the AI/AN population (Artiga). From these figures, it is evident that legislation is being passed to allow for greater coverage in the AI/AN population. This greater coverage will help decrease the disparities in the population. My only criticism is that health care officials allows for too much leniency in the Affordable Health Care Act allowing states to “opt out.” Unfortunately, studies show that the 28 states that have “opted out” are in regions with the highest AI/AN population (Artiga). Moreover, there has also been significant spending increases for Indian Health Services for AI/AN with an estimated 6 billion over the next 5 years that leads me to believe that health officials are proactively trying to