The U.S. Supreme Court ruled in a 5-4 decision that the federal government has been underfunding Native American tribes that manage their own healthcare programs for the past 30 years. The court determined that federal law mandates the U.S. Department of Health and Human Services to cover the overhead costs incurred by tribes when utilizing funds from Medicare, Medicaid, and private insurers.
The ruling, which affirms decisions by the 9th and 10th U.S. Circuit Courts of Appeals, is a significant victory for the San Carlos Apache Tribe in Arizona and the Northern Arapaho Tribe in Wyoming, both of which had filed lawsuits over the inadequate funding. The majority opinion was authored by Chief Justice John Roberts, who was joined by the court’s three liberal justices and conservative Justice Neil Gorsuch, known for his support of Native American rights.
The case centers on the Indian Self-Determination Act (ISDA) of 1975, which allows Native American tribes to administer their own healthcare programs through contracts with the Indian Health Service (IHS). The IHS directly provides healthcare services to approximately 2.8 million Native Americans.
In his dissent, Justice Brett Kavanaugh, joined by the other three conservative justices, argued that the majority ruling upends 30 years of practice and that Congress could have addressed the issue but chose not to.
The decision highlights the ongoing health disparities and underrepresentation faced by Native American communities in the United States, and the need for adequate funding to ensure equitable access to healthcare services.
See: “US must pay more of Native American tribes’ healthcare costs, Supreme Court rules” (June 6, 2024)
