Reuters' report is likely to impact Michigan tribes, as well.

In 2023, Michigan expanded several state programs to allow tribes access to state funds.

Wonder if expanded federal payments will change upcoming Michigan budgets?

https://www.reuters.com/legal/government/us-must-pay-more-native-american-tribes-healthcare-costs-supreme-court-rules-2024-06-06/?

US must pay more of Native American tribes' healthcare costs, Supreme Court rules

By Brendan Pierson   |   June 6, 20243:29 PM EDTUpdated 6 days ago

 

June 6 (Reuters) - The U.S. Supreme Court on Thursday held that the federal government has been under-funding Native American tribes that administer their own healthcare programs for 30 years and must pay potentially hundreds of millions more going forward.

In its 5-4 ruling, the court found that federal law requires the U.S. Department of Health and Human Services to pay the overhead costs that tribes incur when spending money from Medicare, Medicaid and private insurers. The ruling is a victory for the San Carlos Apache Tribe in Arizona and the Northern Arapaho Tribe in Wyoming, which had each sued over the funding.

 

Conservative Chief Justice John Roberts wrote the majority opinion, joined by the court's three liberals and by conservative Justice Neil Gorsuch, a consistent supporter of Native American rights. The ruling affirmed decisions by the 9th and 10th U.S. Circuit Courts of Appeals.

Carter Phillips of Sidley Austin, who represents the San Carlos Apache tribe, called the decision "a huge win for Indian country and for the quality of health care provided on Indian reservations."

 

Adam Unikowsky of Jenner & Block, who argued for the Northern Arapaho Tribe, said it "will promote tribal sovereignty and provide resources for health care in under-served communities."

U.S. Secretary of Health and Human Services Xavier Becerra in a statement called on Congress to ensure stable and adequate funding for HHS's Indian Health Service (IHS) division going forward in light of the ruling. The government had said in court papers that the cost of the funding could be between $800 million and $2 billion annually.

 

The IHS provides health care services directly to about 2.8 million Native Americans. Thursday's decision centers on the Indian Self-Determination Act (ISDA), a 1975 law that allows Native American tribes to take over administration of their own healthcare programs under contracts with IHS.

Those contracts require IHS to provide the same amount of funding it would provide if it were running the program directly, and to cover administrative expenses incurred by the tribe. In 1994, ISDA was amended to make clear that payments from government and private insurance collected by the tribe supplement, and do not replace, IHS funding.

 

Both tribes sued IHS, saying the agency was refusing to cover the administrative costs they incurred in spending insurance money.

The government argued the law did not require them to cover those costs. It said the tribes were free to use the insurance money for a wide range of healthcare-related purposes, meaning they were not part of their contracts with IHS. But Roberts rejected that argument.

The tribes' freedom in using the funds "should not be surprising given ISDA's design to provide tribes greater flexibility in planning and implementing healthcare programs attuned to the needs of their communities," Roberts wrote.

 

He said requiring tribes to take on those costs would effectively penalize them for choosing to administer their own programs.

Justice Brett Kavanaugh, joined by the other three conservative justices, dissented. He said the majority ruling "upends" 30 years of practice, which Congress could have addressed but chose not to.

The cases are Becerra et al v. San Carlos Apache Tribe, No. 23-250, and Becerra et al v. Northern Arapaho Tribe, U.S. Supreme Court, No. 23-253.

 

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