Indian Health Care Improvement Act Made Permanent By Health Care Reform Legislation

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Indian Health Care Improvement Act Made Permanent By Health Care Reform Legislation (PDF)

Reauthorization of IHCIA

The version of the IHCIA signed into law on March 23, 2010, differs in several ways from the original 1976 version. It includes many major changes and improvements to effectuate the delivery of health care services to AI/ANs, including:

• Enhances the authority of the IHS Director, including the responsibility to facilitate advocacy and promote consultation on matters relating to Indian health within the Department of Health and Human Services.
  
  
• Provides authorization for hospice, assisted living, long-term, and home- and community-based care.
  
  
• Extends the ability to recover costs from third parties to tribally operated facilities.
  
  
• Updates current law regarding collection of reimbursements from Medicare, Medicaid, and CHIP (Children’s Health Insurance Program) by Indian health facilities.
  
  
• Allows tribes and tribal organizations to purchase health benefits coverage for IHS beneficiaries.
  
  
• Authorizes IHS to enter into arrangements with the Departments of Veterans Affairs and Defense to share medical facilities and services.
  
  
• Allows a tribe or tribal organization carrying out a program under the Indian Self-Determination and Education Assistance Act and an urban Indian organization carrying out a program under Title V of IHCIA to purchase coverage for its employees from the Federal Employees Health Benefits Program.
  
  
• Authorizes the establishment of a Community Health Representative program for urban Indian organizations to train and employ Indians to provide health care services.
  
  
• Directs the IHS to establish comprehensive behavioral health, prevention, and treatment programs for Indians.21

The inclusion of the IHCIA in the reform legislation was hailed by the National Indian Health Board as a much-needed provision. “No one can deny the intense political climate that has been present in the debates regarding health care reform. However, there is one issue that has remained consistently agreed upon: Indian Country is in dire need of health care reform,” said Reno Franklin, Chairman of the National Indian Health Board.22 Adding to that sentiment, President Obama remarked after he signed the reform legislation that he “believes it is unacceptable that Native American communities still face gaping health care disparities.”23