Supreme Court agrees to review funding fight over tribe health care costs | Courthouse News Service
Thursday, November 30, 2023
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Supreme Court agrees to review funding fight over tribe health care costs

Two tribes won Supreme Court review in their fight to force the government to cover more health care costs.

WASHINGTON (CN) — The Supreme Court agreed on Monday to decide if the government should be responsible for covering more health care costs for Native American tribes.

Tribes from Arizona and Wyoming want the government to cover the overhead costs associated with running their health care programs according to federal law. Appeals courts have split on the questions, leaving the government to ask the justices to issue a final determination on the issue. 

Per their custom, the high court did not provide an explanation for agreeing to hear the cases. There were no noted dissents. 

The tribes before the court have taken advantage of a 1975 law known as the Indian Self-Determination and Education Assistance Act, which allows them to run their own federal programs. Under the law, the tribes and the government come together to form “self-determination contracts” with whatever federal agency would have normally operated the program. 

In these cases, the San Carlos Apache Tribe from rural southeast Arizona and the Northern Arapaho Tribe located on the Wind River Reservation in Wyoming entered into contracts with the Indian Health Service. The tribes agreed to operate the agency’s duties while the government agreed to foot the bill. 

There are three federal laws that have created the conflict before the court. Congress requires the government to provide support costs to tribes from providing agency services. A separate law allows tribes to negotiate with members’ insurance, and yet another law allows tribes to keep those insurance payments to be used on health care costs. 

For the San Carlos Apache Tribe, the additional health care services it provided using the program income resulted in $3 million in increased overhead expenses during a three-year contract. In a similar predicament, the Northern Arapaho Tribe’s two-year contract left it with $1.5 million in support costs.

The tribes asked the Indian Health Service to cover those support costs but the agency refused, arguing those funds were not eligible for reimbursement under their contracts. The tribes sued. 

A lower court dismissed the suit from the San Carlos Apache Tribe but the Ninth Circuit revived the suit. In a similar turn of events, the Northern Arapaho Tribe lost its lower court fight but had the unfavorable ruling reversed on appeal. 

The government asked the court to reverse both rulings, arguing agencies only have to pay for agency-funded activities. 

“The decision below — and a splintered 10th Circuit decision that reached the same result — extend the federal government’s funding obligation in a sweeping fashion to additionally subsidize activities that tribes carry out using funds they receive from non-IHS health care payors,” U.S. Solicitor General Elizabeth Prelogar wrote. “The statutory scheme forecloses that counterintuitive result.”

The San Carlos Apache Tribe did not dispute the need for the high court's review of its case despite prevailing on appeal. The tribe says the government’s reading of the law is insufficient to support the needs of the health care programs and agencies should be responsible for costs associated with providing these services. 

“This conclusion follows from the plain meaning of the statutory text; from the statutory structure, which is designed to place contracting tribes on par with IHS when they step into IHS’s shoes to run the program; and from the venerable canon of interpretation — here incorporated expressly into both the statute and the contract — that ambiguities in statutes affecting Indian tribes must be resolved in favor of the tribe,” Lloyd Miller, an attorney with Sonosky, Chambers, Sachse representing the tribe, wrote

The Northern Arapaho Tribe said its suit provided a better vehicle for the court to review. However, the justices decided to hear both cases. 

The justices also agreed to hear a follow-up to a ruling from its 2022 term involving the Armed Career Criminal Act. In Wooden v. United States, the justices said multiple crimes can be considered to occur during one occasion for sentence guidelines under the Armed Career Criminal Act. The court’s ruling said the occasions clause — used to determine sentencing guidelines — should be considered with the facts of a specific case. 

Implementing that ruling has troubled the lower courts which have failed to provide the necessary fact-finding measures to comply with Wooden. The justices will decide if a jury trial should be used to conduct these inquiries. 

Follow @KelseyReichmann
Categories / Appeals, Criminal, Financial, Government, Health

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