NCAI Action Alert

September 19, 2017

Make your Voice Heard on ACA Repeal Effort and SDPI Reauthorization!

September 30th is the deadline for both utilizing the budget reconciliation process to repeal the Affordable Care Act (ACA) and reauthorizing the Special Diabetes Program for Indians (SDPI). Next week, the Senate may consider legislation introduced by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA), “Graham-Cassidy,” which would repeal the structure and architecture of the ACA and replace it with a block grant given annually to states beginning in 2020. The grant dollars would replace the federal money currently being spent on Medicaid Expansion, ACA tax credits and cost-sharing reduction subsidies.

While the Indian Health Care Improvement Act is preserved under this proposal, it nevertheless violates the federal trust responsibility to Indian tribes by shifting federal dollars to the states and not directly to tribes. In addition, the legislation would greatly impact health services to Tribal Nations due to the proposed cuts to Medicaid. Today, Medicaid represents about 13% of total Indian Health Service (IHS) spending, which means that cuts to the Medicaid program, are really cuts to IHS.

Under the budget reconciliation process, the Republicans need 50 of their 52 members to vote in favor of the proposal. Currently, all of the Democrats are opposed to the measure, along with Republican Senator Rand Paul (KY). The Republican Senators that voted in opposition to the “skinny” repeal in July–Senators John McCain (AZ), Lisa Murkowski (AK) and Susan Collins (ME)–will be critical in determining the outcome.

Call your Senators!

It is critically important that Indian Country’s voice is heard during the Healthcare debate. All Tribes should call their Senators, especially those in Alaska, Maine and Arizona You can find you Senator’s phone number by clicking here.

Your Key Messages
  • The Federal Government, not the states, has a trust responsibility to provide health care to American Indians and Alaska Natives.
  • Medicaid cuts will have significant negative impacts to Indian Country. For over 40 years, Congress has recognized Medicaid as a means to help fulfill the trust responsibility for health to Indian Country.
  • Reauthorization of the Special Diabetes Program for Indians (SDPI), which expires on September 30th, is a top priority for Indian Country.

NCAI Contact Info: 
Josh Pitre, Senior Policy Analystjpitre@ncai.org

Founded in 1944, the National Congress of American Indians is the oldest, largest and most representative American Indian and Alaska Native organization in the country. NCAI advocates on behalf of tribal governments, promoting strong tribal-federal government-to-government policies, and promoting a better understanding among the general public regarding American Indian and Alaska Native governments, people and rights.
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