President Begaye calls for true tribal consultation on Medicaid work requirement mandate

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President Begaye addresses members of the U.S. Health and Human Services' Secretary's Tribal Advisory Committee during a meeting in Fairbanks, Alaska.

FAIRBANKS—President Russell Begaye defended Indian Country’s health and wellness programs this week at a national meeting held at the David Salmon Tribal Hall in Fairbanks, Alaska.
 
President Begaye, who is the U.S. Health and Human Services (HHS) Secretary’s Tribal Advisory Committee (STAC) Delegate for the Navajo Area, confronted the Centers for Medicare & Medicaid Services (CMS) when tribal leaders continued to receive circular answers about the status of the Medicaid work requirements mandate for American Indians and Alaskan Natives (AI/ANs).
 
“The purpose of the twenty-two-page HHS Tribal Consultation Policy is to eliminate health and human service disparities to Native Americans and for HHS to engage in open, continuous, and meaningful consultation. That is the Department’s policy,” President Begaye said.
 
Since January, tribes have continuously requested meaningful tribal consultations from both HHS and CMS officials on their decision to mandate work requirements for American Indians and Alaska Natives (AI/ANs). The administration has been unresponsive to these requests even after the State of Arizona signed H.R. 2228 into law exempting AI/ANs from Medicaid work requirements.
 
Tim Hill, deputy administrator and acting director for CMS & CHIP services said that CMS did engage in consultation with Tribes through letters.
 
“I understand that Indian Country did not think that was ‘meaningful.’ Although Arizona state has taken a unique approach on who has to comply with community engagement requirements in their 1115 waiver request, statutory language permits CMS to mandate work requirements. It does not create an explicit exemption for AI/ANs,” Hill said. “I just hope that tribal leaders aren’t wasting your breath on the issue.”
 
President Begaye said Hill’s response was wholly unacceptable and motioned for the STAC work requirements discussions to cease.
 
“Until true meaningful tribal consultation takes place, as defined under the HHS policy as an actual government-to-government relationship, I request that the committee submit a resolution to halt movement on the issue,” he said.
 
STAC tribal leaders agreed with President Begaye’s motion through unanimous consent. A resolution from STAC is currently being prepared for submission.
 
The administration’s lack of true tribal consultation coupled with CMS’ blatant disrespect to Indian Country during this STAC meeting is a clear indication that a decision to mandate work requirements for AI/AN citizens is a pending threat to tribal sovereignty.

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