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. 2014 Jun;104 Suppl 3(Suppl 3):S263-7.
doi: 10.2105/AJPH.2013.301682. Epub 2014 Apr 22.

American Indian health policy: historical trends and contemporary issues

Donald Warne  1 , Linda Bane Frizzell
Affiliations

American Indian health policy: historical trends and contemporary issues

Donald Warne et al. Am J Public Health. 2014 Jun.

Abstract

The United States has a trust responsibility to provide services to American Indians and Alaska Native (AI/AN) persons. However, a long-standing history of underfunding of the Indian Health Service (IHS) has led to significant challenges in providing services. Twentieth century laws, including the Snyder Act, Transfer Act, Indian Self-Determination and Education Assistance Act, and Indian Health Care Improvement Act (IHCIA) have had an effect on the way health services are provided. IHCIA was reauthorized as part of the Patient Protection and Affordable Care Act (ACA). Several provisions in ACA allow for potential improvements in access to services for AI/AN populations and are described herein. Although policy developments have been promising, IHS underfunding must be resolved to ensure improved AI/AN health.

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Figures

FIGURE 1—
FIGURE 1—
2009–2010 Indian health expenditures per capita compared with other federal health care expenditures per capita. Note. FEHB = Federal Employee Health Benefits; IHS = Indian Health Service. Source. National Tribal Budget Formulation Workgroup.
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References

    1. Prucha FP. American Indian Treaties: The History of a Political Anomaly. Berkeley, CA: University of California Press; 1994. p. 1.
    1. Seminole Nation v United States, 316 US 286 (1942).
    1. Cherokee Nation v Georgia, 30 US (5 Peters) 1 (1831).
    1. DeJong DH. If You Knew the Conditions: A Chronicle of the Indian Medical Service and American Indian Health Care, 1908-1955. Lanham, MD: Lexington Books; 2008. p. 8.
    1. Moorehead WK. The American Indian in the United States: 1850-1914. Whitefish, MT: Kessinger Publishing; 2007. p. 85. Reprint of 1914 original.

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