Health education, mental health support, and help with unmet healthcare needs are available for American Indians through the Indian Health Care Improvement Act (IHCIA).
By working with tribal organizations, allied health professionals, and private entities, the IHCIA combats preventable health disparities and improves access to community-based health services for Native American households.
With IHCIA support, tribal health programs can implement disease prevention services, develop mental health plans, treat fetal alcohol spectrum disorders, and provide diabetes care, all while fostering training for qualified allied health professionals.
The Act strengthens the delivery of medical services for American Indians and Alaska Natives, empowering caregivers to access the tools and resources needed to ensure their loved ones receive life-saving care.
We use the term "Indian" in this article to align with the terminology used in the Indian Health Care Improvement Act (IHCIA); however, we recognize and respect "American Indian" or "Indigenous American" as the preferred terms in many communities.
The IHCIA is a foundational law that specifically addresses the healthcare needs of American Indians and Alaska Natives. Enacted in 1976, it authorizes the Indian Health Service (IHS) and provides a legal framework for programs and funding to improve access to healthcare for Indigenous communities.
Key features:
The Affordable Care Act (ACA), signed into law in 2010, is a comprehensive healthcare reform act designed to expand insurance coverage and improve healthcare accessibility for all Americans. Importantly for Native communities, it permanently reauthorized the IHCIA, ensuring its programs would not expire.
The American Recovery and Reinvestment Act (ARRA), enacted in 2009, was a stimulus package aimed at jumpstarting the economy during the Great Recession. While it was not specific to Native healthcare, it allocated significant funding to healthcare infrastructure, including the IHS.
Think of IHCIA as the blueprint for a house (Native healthcare system). The ACA ensured the blueprint would always be followed and even added extra rooms for long-term care and behavioral health. ARRA, meanwhile, provided the construction materials (funding and infrastructure improvements) to build and modernize the house more effectively.
The Indian Health Care Improvement Act (IHCIA) permanently authorizes the Indian Health Service (IHS) to deliver health care to nearly 2 million American Indians and Alaska Natives. This Act addresses crucial health care needs by expanding mental and behavioral health care programs. It also ensures more long-term care services like home health care and assisted living. Furthermore, the IHCIA facilitates new health service projects and improves the Contract Health Services program. This helps streamline referrals for care, essential for many Native communities.
The IHCIA serves as the legal foundation for health services for American Indians and Alaska Natives. Its permanence under the Affordable Care Act since March 23, 2010, enhances access to care by allowing states to receive 100% Federal Medical Assistance Percentage for Medicaid services. Additionally, it mandates that the Health and Human Services Secretary publish an annual list of Indian Health Scholarship recipients to support future health professionals in these communities.
The Indian Health Service (IHS) has long faced funding issues that impact health care for American Indian and Alaska Native communities. The IHCIA aids workforce availability via scholarships and recruitment grants, addressing salary gaps to attract healthcare providers. This support is essential for overcoming resource shortages and ensuring sustainable health care.
The IHCIA, enacted on September 30, 1976, enhances health care by supporting training for health professionals. Title I directs grants to tribal organizations to educate Native individuals in health fields and authorizes scholarships for promising high school graduates, funded from 1978 to 1984. However, chronic underfunding of the Indian Health Service continues to impact training resources and quality of care.
The Indian Health Service Loan Repayment Program supports health professionals by repaying educational expenses for service. Participants must stay in good standing and meet their service commitment; otherwise, they face repayment demands based on unmet service duration. This program aids recruitment and retention in Indian health, addressing financial barriers to medical education.
The IHCIA permits contracts with urban Indian organizations to meet the health needs of people living in urban centers. These organizations connect communities to public/private resources, identify unmet health care needs, and assess the local Indian population. The Act allows them to access federal facilities and set appropriations, increasing from $5 million in 1978 to $15 million by 1980.
Despite its intentions, several limitations and challenges have affected the effectiveness of the IHCIA:
Addressing these challenges requires sustained efforts to secure adequate funding, improve workforce recruitment and retention, enhance infrastructure, streamline administrative processes, and integrate culturally sensitive practices into healthcare delivery for Native American populations.
Do you need more IHS resources? Find practical websites below:
