August 02, 2019

Udall, Khanna Introduce Bipartisan, Bicameral Bill to Improve Health Care Access for Native American Veterans

Bill will ensure equal access to culturally competent care for urban Native veterans in cities across the United States

WASHINGTON – Today, U.S. Senator Tom Udall (D-N.M.), vice chairman of the Senate Committee on Indian Affairs, and U.S. Representative Ro Khanna (D-Calif.) announced introduction of the Health Care Access for Urban Native Veterans Act, a bill to improve health care access for Native American Veterans by providing Department of Veterans Affairs (VA) coverage for care that Native American veterans receive at urban Indian health centers.  This legislation would help Native American veterans acquire culturally competent care, while at the same time helping relieve the burden on the VA system.

“We owe all veterans a debt for their service to our country, and this legislation will ensure more Native veterans have equal access to timely, culturally-competent care regardless of where they choose to live after leaving their military service,” said Udall. “I am proud this bill continues my work toward equitable and effective health care for all Native communities.”  

“Native Americans serve in the military at a higher rate than any other population, and over 70 percent of Native Americans live in urban areas. Urban Indian organizations, like the Indian Health Center of Santa Clara Valley, fill a crucial gap in the health care system for Native Americans that do not have access to more remote facilities run by the Indian Health Service. To honor their service to the United States, we must ensure that Native veterans have access to the care that best fits their cultural and health needs,” said Khanna.

The Indian Health Service (IHS) is the primary federal agency responsible for providing health care to Native Americans through a series of federally operated facilities, Tribally run facilities, and urban Indian health centers operated by urban Indian organizations. Federal law allows the VA to reimburse federally-operated and Tribally-operated IHS facilities for services they provide to Native American veterans. 

However, the law does not currently allow urban Indian health centers to participate in the same service reimbursement agreements as other two branches of IHS. This exclusion limits the ability of those urban facilities to maintain and expand services sought by Native American veterans and other Native American patients.  The Health Care Access for Urban Native Veterans Act will correct this exclusion and allow Native American veterans to have access to the timely, culturally competent care they deserve.

In addition to Udall and Khanna, the bill is cosponsored by U.S. Senators Jerry Moran (R-Kan.), Jon Tester (D-Mont.), ranking member of the Senate Committee on Veterans Affairs, Mike Rounds (R-S.D.), and Tina Smith (D-Minn.) and U.S. Representatives Paul Gosar (R-Ariz.), Ben Ray Luján (D-N.M.), Don Young (R-Alaska), Gwen Moore (D-Wis.), Paul Tonko (D-N.Y.), Greg Gianforte (R-Mont.), Don Bacon (R-Neb.), and Deb Haaland (D-N.M.). 

"Native Americans have served our nation in uniform at a historically high rate, but too often these veterans face barriers and roadblocks when it comes to receiving the care and benefits they’ve earned,” said Tester, Ranking Member of the Senate Veterans' Affairs Committee. "Our bipartisan bill provides Native American veterans in Montana with the health care and services they need when returning home from military service. It also expands Native American veterans’ access to care by streamlining reimbursements to clinics that provide essential care to these men and women in uniform.”

"Right now, dozens of clinics around the country that serve Native veterans-including several in Minnesota-aren't being reimbursed for care they provide like their federally or tribally operated counterparts. Clinics that serve Native veterans in urban areas should be reimbursed just the same as clinics in any other community," said Smith. "These are clinics that treat things like mental health--including PTSD--chronic diseases, and addiction. And they do so in a culturally sensitive way meaning that Native vets often seek care at these facilities instead of at the VA. Our bill would make a simple fix to make sure clinics get the same level of reimbursement no matter where they're located." 

“All veterans deserve to have access to the benefits and services they have earned, but limitations in the law are preventing Native American veterans from seeing providers at urban Indian health centers. We’re putting a bill forward that will ensure Indian health programs are eligible for reimbursements from the VA, so that Native American veterans get the services they need in a timely manner while giving the VA more options to deliver services in a timely manner,” said Haaland, Co-Chair of the Congressional Native American Caucus.

“Native American veterans have earned the right to quality, culturally-sensitive health care. Our country is indebted to Native veterans in this respect and more. I stand beside Rep. Khanna as he calls attention to the unique shortfalls that exist for Native veterans in our healthcare systems. The majority of Native Americans live in urban areas, and yet problems persist in VA and Indian Health Service reimbursements that reduce patients’ access to care. The Health Care Access for Urban Native Veterans Act will close gaps in health equity for Native veterans. I hope to quickly see its passage through the U.S. House,” said Assistant Speaker Luján.

“I am proud to be an original cosponsor of the Health Care Access for Urban Native Veterans Act. This bill will amend the Indian Health Care Improvement Act to authorize urban Indian organizations to enter into arrangements for the sharing of medical services and facilities,” said Gosar. 

“I have long supported giving veterans a choice in how they access their health care. Alaska Native veterans and veterans from Native communities across our country deserve to seek care at facilities that are close to their homes and from doctors who they feel most comfortable with. This legislation is simple: if a Native veteran accesses care from an Urban Indian Organization clinic, then that clinic should be reimbursed by the VA for services provided. Our veterans risked everything to keep our country safe, and this legislation is an important part of ensuring that our heroes receive the care they have earned. I am grateful to Representatives Khanna, Moore, and Gosar for their leadership on this issue and look forward to working with them to get it past the finish line,” said Young.

“This partnership supports eligible Native American veterans in Nebraska and provides access to quality health care closer to their home. Passing this legislation would promote accessible public-health services by increasing care coordination, collaboration, and resource-sharing between the agencies,” said Bacon. 

“This legislation would ensure that all tribal health programs serving Native veterans can be reimbursed by the VA. Native American veterans bravely served our country. We need to ensure they are taken care of and receive care that meets their unique cultural and social needs,” said Moore.

As of 2018, the VA had partnered with 188 federally-operated and Tribally-operated IHS facilities to provide direct care and reimbursement for services ranging from primary care to behavioral health. These agreements have resulted in improved access to care for more than 9,300 Native American veterans. 

With the Health Care Access for Urban Native Veterans Act, 37 urban Indian nonprofit IHS facilities operating in 19 states will be able to partner with VA on similar reimbursement agreements, including the First Nations Community HealthSource in Albuquerque, New Mexico, and the Indian Health Center of Santa Clara Valley facility in San Jose, California.

“At First Nations Community HealthSource, we never turn anyone – veteran or not - away. Native veterans in Albuquerque consider our facility a safe, accessible space to receive health care,” said Linda Son-Stone, Chief Executive Officer of First Nations Community HealthSource. “With critical underfunding, this legislation would allow all Urban Indian Organizations to provide more services for the necessary care we already provide to our Native veterans. Thank you, Senator Udall, Representative Haaland, and all of the legislators who made Native veterans a priority.”

“The National Council of Urban Indian Health has made it a priority to ensure that Urban Indian Organizations are included in the IHS-VA MOU to help provide health care to American Indian and Alaska Native veterans,” said Sonya Tetnowski, Vice President of the National Council of Urban Indian Health and CEO of the Indian Health Center of Santa Clara Valley. “As a Native veteran myself, I understand the importance of coming home and knowing I have a safe space to receive care. Thank you to my own Representative Ro Khanna, and we are grateful for the leadership of the 116th Congress in introducing this landmark legislation.” 

The bill is supported by the National Congress of American Indians (NCAI), National Council of Urban Indian Health (NCUIH), Iraq and Afghanistan Veterans of American, and VoteVets. 

“The Health Care Access for Urban Native Veterans Act is important legislation to ensuring that our Native veterans in urban areas are no longer left behind,” said Francys Crevier, NCUIH Executive Director. “Now, the Department of Veterans Affairs will be able to fully work with the 41 Title V Urban Indian Organizations that are integral to the Indian Health Service IHS/Tribal/Urban system who are already providing critical resources for American Indian and Alaska Native veterans who have served the United States as part of their dual trust obligation not only for veterans but also for American Indians and Alaska Natives.”

The full text of the legislation can be found HERE.

###