Starting on Saturday, Montanans can begin buying health insurance for next year on the healthcare.gov website. One group in the state that’s been slow to do so are Native Americans.
Native Americans are exempt from the health law’s requirement to have insurance coverage. That’s because they’re eligible for health care through the Indian Health Service, or IHS, since the federal government promised in treaties to provide health care in exchange for tribes giving up their land. How’s the IHS doing?
Montana Senator Jon Tester, who sits on both the Veterans and Indian Affairs committees, puts it this way:
"The VA is actually in better shape than the Indian Health Service. It is really in tough shape, it basically runs out of money about nine months into the fiscal year, I mean, it’s really in crisis."
The IHS budget crisis means tribal members can often only get health care when they’re in immediate danger of losing life or limb, says Lesa Evers a Blackfeet descendent and member of the Turtle Mountain tribe who works for Montana’s state health department.
"If you have an individual who really requires knee surgery from trying to play basketball with their kids, or whatever they tried to do, they may never have that opportunity to have that knee surgery."
Buying private health coverage would give them access to more health care providers, and subsidies under the health care law are making insurance affordable for many Indians. But efforts to get them to enroll in private coverage aren’t bearing much fruit yet.Less than half a percent of people who enrolled in health coverage nationwide last year are Native American. Evers says there needs to be more outreach to tribes.
"I think people need education first," says Evers. "They need to understand it, to learn about it, and they want to do that from people they trust. And that’s how people communicate in Indian Country. It’s a lot about what your friends say, and what family say. That’s who they trust."
Evers says that so far only a handful of health care navigators have been deployed to reservations, or to the estimated one-half of the Native population that lives off of reservations, to help them understand the health care law. It’s estimated that there are about two million people who are members of federally recognized Native American tribes nationwide.
