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ANA and CMS Health Care Marketplace Enrollment Outreach Partnership

Photo of Native American family that shows a dad and a mom with three children.This summer, and throughout this year, the Administration for Native Americans will partner with the Centers for Medicare and Medicaid Services (CMS) Tribal Affairs Group to expand outreach and education to Tribes to provide information about the Affordable Care Act (ACA) and to increase enrollment into CMS programs: Medicare and Medicaid and Children’s Health Insurance Program (CHIP). 

ANA will enter into a contract with a Training and Technical Assistance (TTA) provider who will be the key point of contact for this outreach effort.  They will work with ANA’s four technical assistance centers, which reach dozens of communities each year though our ongoing pre-application and project development training sessions Additional ACF program office TTA providers will also be the conduits to get information out about this important health initiative.

CMS has found that partnering with schools and civic organizations that interact with families are the best way to get information out about eligibility.  In Native American communities, word of mouth from a trusted source is important to overcoming barriers that individuals may experience in accessing health care.  ANA’s relationship with Tribal communities and Native American-serving organizations will be an important link to passing this vital information along.

Enrolling more families through the Health Insurance Marketplace that includes Medicaid and CHIP provides important benefits to communities and families.  Health care facilities that depend only on Indian Health Service (IHS) funding, are missing out on opportunities to expand their services.  CMS reimbursements to IHS are additional resources for health care services provided to tribal communities. When Indian health care providers invest the time and effort in enrolling their patients in these federal health insurance programs, they save money in contract health costs when patients need to be referred out of the facility for specialized care.  The CMS Tribal Affairs Group produced a wonderful video that highlights the impact that outreach can have in their show, The Medicine Dish.  In this video, San Felipe Pueblo details how their push to enroll families into CHIP and Medicaid resulted in less dental disease (from 70 to 90 percent to less than 25 percent) in their Head Start children, and enough money to expand the program to the elementary school.  As the Head Start Director said, “I would rather invest $60,000 this year for 96 children, than $60,000 years later for one adult who needs dental surgery, and suffers from the pain and agony they would have to through.”

More American Indian and Alaska Native families are living outside of reservations than ever before, nearly 80 percent according to the 2010 U.S. Census.  That means access to an Indian Health Service or other facility for federally enrolled American Indians and Alaska Natives may not be convenient or economically possible.  In this case, uninsured children and parents often forgo preventive care and delay medical care unless it is an emergency situation. Since emergency care is expensive, this puts even more of a burden on the family.  Previously parents have decided not to enroll their children in sports, for fear that they if they get hurt, they won’t be able to afford the hospital visit.

Despite all of these benefits, enrolling eligible children and families has not been easy; partially because of the misperception that Indian Health Service or access to a Tribal Health Facility means they have health insurance.  Other barriers include the paperwork, having to answer a "million" questions and provide personal information to the government, or sometimes it’s not knowing where to go or lacking a way to get there.  These are the barriers that we hope our partnership can address. By sharing the many ways that enrolling will benefit us and the next seven generations.

Lillian Sparks, a Lakota woman of the Rosebud and Oglala Sioux Tribes, is the commissioner of the Administration of Native Americans.  Sparks was confirmed by the U.S. Senate as the commissioner on March 3, 2010, and was sworn in on March 5, 2010.  She has devoted her career to supporting the educational pursuits of Native American students, protecting the rights of indigenous people, and empowering tribal communities.

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