Authors: National Council of Urban Indian Health

Publication Year: 2009

Last Updated: 2016-04-06 

Journal: NCUIH

Keywords: H.R.2708, Legislative Update, NCUIH, National Council of Urban Indian Health, IHCIA, Indian Health Care Improvement Act, DHHS, Health and Human Services, Urban Indians, affordable care act, aca

Abstract:

Due to the structure of the Indian Health Care Improvement Act separate definitions for Indians who live on the reservations or near their tribal homes (Indians) and Indians who live off the reservations (Urban Indians) were necessary despite the fact that the distinction is largely legal and academic rather than reflecting and actual distinction. However, under the previous Administration, Executive branch agencies such as DHHS began actively interpreting any law that did not specifically include urban Indians or urban Indian organizations to exclude the urban Indian community. This causes particular problems with regard to third party billing, conferring with agencies on issues impacting urban Indian health, and fully developing the urban Indian health program. The automatic assumption when interpreting IHCIA that urban Indians are excluded if not explicitly included is a long running issue and not one easily solved on the administrative level. Given this interpretive rubric used by the Executive branch for interpreting federal Indian law, it is particularly important to specifically include urban Indians in any statement of federal policy or Congressional intent as the absence of urban Indians will be interpreted as a specific intent to exclude.

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