MADISON, WIS. — A change in federal policy this year creates an opportunity to improve access to health care for Native Americans in Wisconsin. A new report urges state and tribal health officials to seize this chance to close “alarming disparities” in health care and health outcomes between Native Americans and whites in Wisconsin.
The new report, prepared by the Wisconsin Council on Children and Families (WCCF), reveals very large disparities in health indicators between whites and Native Americans in Wisconsin. For example, the report notes that Native Americans in Wisconsin live about 14 years less than whites. In 2014, the average age at death for Native Americans was just 63 years, compared to 77 years for white Wisconsinites.
Sashi Gregory, WCCF’s health care analyst, pointed to several additional indicators of large disparities that she said illustrate the need for remedial action. “The infant mortality rate for Native American children in Wisconsin was 69 percent higher than the rate for white children during the period 2012 to 2014,” Gregory said, “and the diabetes mortality for Native Americans was almost four times the rate for white Wisconsinites.”
The federal government has a longstanding commitment to fully fund health care for low -income Native Americans, which it does primarily by paying for clinics operated or funded by Indian Health Services (IHS). However, Gregory says “the clinics are chronically unfunded and there are large gaps in the types of health services that are provided.”
Under the new policy announced in February, the federal government will pay the full cost of a broader range of Medicaid health care services for Native Americans. Up until this year, full federal funding was only available for services provided at IHS/ tribal clinics, and not for care that the same patients have to go somewhere else to receive. The new policy will also pay the full Medicaid costs of other care provided to Native Americans, if it is delivered by providers under contract with an IHS /tribal clinic and that clinic refers the Medicaid patient and continues to oversee their care.
The policy change could yield significant savings in the Medicaid budgets of states with substantial Native American populations. In South Dakota, for example, officials are exploring the possibility of using the savings to pay for the state share of costs for an expansion of Medicaid eligibility.
Gregory said it is too soon to know if there will be significant savings in Wisconsin, and she added that the extent of those savings is not the key question. “The much more important issue,” Gregory said, “ is figuring out how best to take advantage of the new opportunity to fill gaps in health care services for Native Americans in Wisconsin, including things like mental health services and substance abuse treatment.”
Jerry Waukau, health administrator of the Menominee Indian Tribe of Wisconsin, said that tapping the full potential of the broader eligibility for 100 percent federal funding will not be a simple thing to accomplish because there are administrative challenges for tribal officials and the Wisconsin Department of Health Services to overcome.
“Despite those challenges, we’re optimistic that the policy change provides an avenue for removing some of the barriers to increasing access to care and improving health care outcomes for tribal members,” Waukau said. “The tribes look forward to working with the state to develop startup and ongoing funding mechanisms to assist tribes to implement these new agreements and work to design a Medicaid program to better address Native America health disparities in the state by increasing access to and coordination of care.”
The WCCF report, Closing Gaps in Native American Health , can be found at: http://www.wccf.org/publication/closing-gaps-native-american-health/
The Wisconsin Council on Children and Families is a multi- issue policy research and advocacy organization promoting statewide polices that ensure a safe and health future for every child in Wisconsin. For more information, visit www.wccf.org.