NCAI News: Indian Health Care Improvement Act Permanent: Supreme Court Upholds Affordable Care Act

June 28, 2012 –

Indian Health Care Improvement Act Permanent;
Supreme Court Decision Upholds Reauthorization
NCAI to stay focused on improving health care and protecting legislation

Washington, DC – In a 5-4 decision the Supreme Court has upheld the constitutionality of the Affordable Care Act (ACA), affirming the permanent reauthorization of the Indian Health Care Improvement Act (IHCIA) which passed along with the ACA.


“This is an important step for health care in Indian Country; the permanence of the Indian Health Care Improvement Act has been affirmed and NCAI will stay focused on working with all members of Congress to uphold the trust responsibility to tribes,” said Jefferson Keel, President of NCAI, the nation’s oldest and most representative American Indian and Alaska Native advocacy organization. “Moving forward, we are focused on improving health care for Indian Country, while ensuring the Indian Health Care Improvement Act remains protected and implemented as enacted.”


The IHCIA permanently authorizes daily health care delivery to nearly 2 million American Indians and Alaska Natives served by the Indian Health Service (IHS), who are in critical need of improved health care services. A snapshot of health conditions highlights the critical need for improving health care in Indian Country; Native people suffer from higher rates of diabetes and related illness, heart disease, and substance abuse than any other group.


The IHCIA authorizes new programs within the IHS to ensure the Service is more equipped to meet its mission to raise the health status of American Indians and Alaska Natives to the highest level.

For example, it includes:

  • Authorities for new and expanded programs for mental and behavioral health treatment and prevention;
  • Expanded authorities for long-term care services, including home health care, assisted living and community-based care;
  • New authorities for development of health professional shortage demonstration programs;
  • Expanded authorities for funding of patient travel costs;
  • New authorities for demonstration projects for innovative health care facility construction;
  • New authorities for the provision of dialysis services;
  • Improvements in the Contract Health Services program, which pays for referrals;
  • New authorities for facilitation of care for Indian veterans; and
  • New authorities for urban Indian health programs.

The passage of the IHCIA on March 23, 2010 represented a fourteen year-long effort by NCAI, tribal leaders, and advocates to make permanent the legislative commitment by the federal government to deliver health care for American Indian and Alaska Natives. The IHCIA was originally passed in 1976 and last reauthorized in 2000.