Republican “Trumpcare” Health Bill Would Harm Tribal Communities

by Staff Reporter / Jul 14, 2017 / comments

Republican “Trumpcare” Health Bill Would Harm Tribal Communities

Recent efforts by Republicans in Congress and the Senate to repeal the Affordable Care Act and replace it with what is informally called “Trumpcare” has been drawing concern across New Mexico as it is projected to cause hundreds of thousands of New Mexicans to lose their health insurance. Republican leadership in the Senate has been attempting to amend the bill to garner enough votes to pass, but a new report from the Washington, DC-based Center on Budget and Policy Priorities is causing further concern for several Senators, including New Mexico’s Senators Udall and Heinrich who have voiced opposition to the bill.

The report from the Center on Budget and Policy Priorities projects that the Republican bill would cause the uninsured rate among Native Americans in New Mexico to jump an estimated 232 percent, due to large reductions in Medicaid.

“The Senate Republican health bill would be devastating to Native American people living in New Mexico,” said James Jimenez, executive director of New Mexico Voices for Children. “Our tribal communities are the cultural backbone of our state and have proven their resiliency despite centuries of challenges. These communities already face significant barriers to getting health care, despite centuries-old treaties and promises. A bill that makes things worse is unacceptable.”

The Senate bill would:

  • effectively end the Affordable Care Act’s expansion of Medicaid to adults, through which 45,600 of New Mexico’s American Indians gained coverage;
  • dramatically cap and cut Medicaid, likely forcing states to cut eligibility, benefits, and provider rates. An exemption in the bill makes it appear that American Indians would be unaffected by this change, but as these cuts would apply to New Mexico’s entire Medicaid program it’s unlikely that any group will be safe; and
  • eliminate subsidies, known as cost-sharing reductions, that help low-income New Mexicans, including 45,600 American Indians, afford out-of-pocket health costs like copays and deductibles.

The Senate bill, as currently drafted would also weaken Indian Health Service (IHS) and Tribal facilities, for which Medicaid is a key source of financing. The bill’s Medicaid cuts would take revenue from IHS and Tribal facilities, which advocates predict would force them to ration care, as they did before the Affordable Care Act.

American Indians and Alaska Natives face persistent health disparities, including a high uninsurance rate, barriers to accessing care, and significant physical and mental health needs.  Like many other groups, Native Americans have benefited greatly from the Affordable Care Act’s coverage expansions. Nationally, the uninsured rate among American Indians and Alaska Natives has fallen by more than a quarter, from 29 percent in 2010 to 21 percent in 2015. The Senate Republican health bill would reverse these gains.

“There are many opportunities for Congress to improve our health care system,” said Jimenez.  “But this bill can’t be fixed: the Senate needs to start over and take a different, bipartisan approach.”

The CBPP’s full report is available online here: https://www.cbpp.org/research/health/coverage-for-american-indians-and-alaska-natives-at-risk-under-senate-gop-health.