O'Halleran Leads Bipartisan Letter Against Medicaid Work Requirements on Tribal Communities

WASHINGTON, DC - Today, Congressman Tom O'Halleran (AZ-01) sent a bipartisan letter signed by 33 other members of Congress to Health and Human Services Secretary Alex Azar regarding reports that the Centers for Medicare and Medicaid Services would subject American Indian and Alaska Native communities to state-imposed work requirements in the Medicaid program.

Citing the Constitutional obligations the federal government must uphold, the lawmakers requested information regarding HHS's consultation with tribal governments and the process by which CMS officials reached the decision.

"As you know, tribes are currently exempt from certain coverage requirements under the Affordable Care Act," wrote the lawmakers, "Not only would refusal to exempt tribes from work requirements sought by some states ignore legal and administrative precedent and violate our trust obligations, it would erect significant barriers to care for vulnerable communities. While imposing these types of requirements in the overall Medicaid population would have serious effects on health and financial stability for millions of Americans, the implications for tribal communities are alarming."

The average unemployment rate in Indian Country was 12 percent in 2016, almost three times higher than the national average. Some communities face unemployment rates well above 50 percent. Drug overdose rates are well above the national average. Diabetes rates are almost twice the national average.

"Reducing access to health care among economically stressed communities with high rates of chronic disease would undermine important progress made in recent years to expand coverage and treatment options. The unique relationship between the federal government and tribes is enshrined clearly in the Constitution. Any actions to undermine this fundamental relationship is a broken promise to Indian Country. Instead of breaking our promises, we ought to be committed and united in improving access to quality health care for all tribal communities."

The lawmakers requested the following information from Secretary Azar:

1. Any reports, documents, memos, or reviews used by HHS as part of its process for this decision;
2. A full list of all consultations with tribal stakeholders held prior to HHS’s decision;
3. An explanation for cancelling your appearance at HHS’s annual budget consultation meeting with tribal representatives in Washington, D.C. last month;
4. An estimate of litigation costs to HHS if the agency moves forward with implementing this decision.

Read the full letter here.