As stated in treaties with tribes, health care is guaranteed to American Indian and Alaska Native people in perpetuity in exchange for the millions of acres of lands—the lands that now make up the United States.
NCAI is committed to ensuring that this responsibility is upheld and that the Indian Health Service, Indian Country’s health system, is brought into the 21st Century.
Across every indicator, American Indian and Alaska Natives face massive disparities in health. Native people suffer from higher rates of diabetes and related illness (r1), heart disease (r2), and substance abuse (r3) than any other group. As a result, the life expectancy of American Indian and Alaska Native people is nearly 6 years less than any other race or ethnic group in America—72.4 versus 77.8 for the general population (r4). Coupled with the rising costs for health-care delivery and the inadequate access to treatment, many Native communities are facing unmanageable rates of health issues.
The federal government fulfills its responsibility to provide health care through the Indian Health Service (IHS). IHS oversees the delivery of health services through direct IHS, tribally operated, and urban health clinics. More than 2000 facilities provide primary care and limited dental services to tribal citizens and descendants.
Since the passage of the Affordable Care Act (ACA) and the permanent reauthorization of the Indian Health Care Improvement Act (IHCIA) in 2010, NCAI has worked closely with federal agencies to ensure implementation maximizes each provision’s impact in tribal communities.
The passage of the ACA and IHCIA provided Indian Country with new opportunities to ensure the health, wellness, and strength of tribal citizens and communities. Provisions of the ACA offer American Indians and Alaska Natives improved insurance protections, such as no-cost preventative services, elimination of lifetime caps on health coverage, and prohibitions on denial of insurance coverage to children with pre-existing conditions. The law will provide a series of lasting changes, many of which are just starting to bring a greater quality of life to all tribal citizens. However, full implementation of all pieces will not be realized until 2014.
- National Center for Health Statistics, Health, United States, 2007, With Chartbook on Trends in the Health of Americans.
- Trends in Indian Health 1998?1999. Indian Health Service.
- TEDS Report: Substance Abuse Treatment Admissions age 12-14; SAMHSA publication May 2011
- National Vital Statistics Reports, US States Life Tables, 2003. (accessed April 2008).
Swinomish Indian Tribal Community v. Alex M. Azar, II, et al.
Mar 18, 2020
Analysis of President's FY 2016 Budget Request
Feb 04, 2015
The Affordable Care Act & Indian Country
Mar 29, 2012
Moving Indian Country Forward, Health Care Reform 1 Year Later
Mar 23, 2011
Testimony & Speeches
NCAI President Fawn Sharp Testimony for House Committee on Oversight and Reform Select Subcommittee on the Coronavirus Crisis Hearing on "An Unequal Burden: Addressing Racial Health Disparities in the Coronavirus Pandemic"
Jun 04, 2020
Testimony - S.246 The Alice Spotted Bear and Walter Soboloff Commission on Native Children
May 18, 2016
Testimony - FY 2017 Tribal Programs House Labor, Health & Human Services, and Education Subcommittee
Apr 15, 2016
Ensuring Access to Over-the-Counter Contraception for American Indian and Alaska Native Women
Nov 13, 2020
A Call to Congress to Support an Indefinite Appropriation for The Indian Health Service to Fund Section 105(I) Lease Obligations Under The Indian Self-Determination And Assistance Act
May 31, 2019
A Call to Congress to Support FY 2020 Indian Health Service Funding
May 31, 2019
NCAI Calls for Immediate and Thorough Investigation of Access to Care for Cheyenne River Sioux Tribal Members with COVID-19
Oct 16, 2020
Cubano e Indio Americano: Sovereignty in Action
Jul 18, 2016
National Native Organizations Receive Funding to Pursue First Kids 1st: Every Native Child is Sacred Initiative
Jun 14, 2016