Preserve the Indian Health Care Improvement Act

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TITLE: Preserve the Indian Health Care Improvement Act

WHEREAS, we, the members of the National Congress of American Indians of the United States, invoking the divine blessing of the Creator upon our efforts and purposes, in order to preserve for ourselves and our descendants the inherent sovereign rights of our Indian nations, rights secured under Indian treaties and agreements with the United States, and all other rights and benefits to which we are entitled under the laws and Constitution of the United States, to enlighten the public toward a better understanding of the Indian people, to preserve Indian cultural values, and otherwise promote the health, safety and welfare of the Indian people, do hereby establish and submit the following resolution; and

WHEREAS, the National Congress of American Indians (NCAI) was established in 1944 and is the oldest and largest national organization of American Indian and Alaska Native tribal governments; and

WHEREAS, the Indian Health Care Improvement Act (IHCIA) (P.L. 94-437) was enacted in 1976 to provide “the highest possible health status to Indians and to provide existing Indian Health Services with all resources necessary to effect that policy;” and

WHEREAS, IHCIA serves as fundamental legislation for the Indian Health Service, tribal, and urban Indian health programs in fulfillment of the federal government’s trust responsibility; and

WHEREAS, permanent reauthorization of the IHCIA (S. 1790) was enacted in 2010 with the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148); and

WHEREAS, IHCIA had been worked on for over a decade and was tacked onto the ACA as a vehicle to get IHCIA passed; and

WHEREAS, IHCIA passed with the ACA but is separate from the ACA; and

WHEREAS, a repeal of the ACA in its entirety would also repeal the permanent reauthorization of IHCIA and Indian provisions in the ACA, such as, Section 2901(b)-Payor of Last Resort, 2901(c)-Facilitating Enrollment of Indians Under Express Lane Option, 2902-Elimination of Sunset for Reimbursement for all Medicare Part B Services Furnished by Certain Indian Hospitals and Clinics, and Title IX, Section 9021-Exclusion of Health Benefits Provided by Indian Tribal Governments as Taxable Income; and

WHEREAS, IHCIA and Indian provisions in the ACA have significantly improved and strengthened the Indian health care system; and
WHEREAS, IHCIA has improved workforce development and recruitment of health professionals in Indian country; and

WHEREAS, IHCIA provided new authorities to fund facilities construction as well as maintenance and improvement funds to address priority facility needs; and

WHEREAS, IHCIA created opportunities to improve access and financing of health care services for Indians such as the provision for the Indian Health Service to carry out long term care related services and reimbursement for same; and

WHEREAS, IHCIA has been instrumental in modernizing the delivery of health services provided by IHS.

NOW THEREFORE BE IT RESOLVED, that the National Congress of American Indians (NCAI) does hereby support and request preservation of the permanent reauthorization of Indian Health Care Improvement Act as to any repeal of the Patient Protection and Affordable Care Act; and

BE IT FURTHER RESOLVED, that the NCAI also hereby supports and requests retention of the Indian provisions in the ACA; and

BE IT FINALLY RESOLVED, that this resolution shall be the policy of NCAI until it is withdrawn or modified by subsequent resolution.


The foregoing resolution was adopted by the General Assembly at the 2017 Midyear Session of the National Congress of American Indians, held at the Mohegan Sun Convention Center, June 12 to June 15, 2017, with a quorum present.