Medicaid’s Role in Health Care for American Indians and Alaska Natives : MACPAC

Medicaid is one of several programs that play a meaningful role in financing health services for American Indian and Alaska Native (AIAN) people: it provided health insurance coverage for more than one-third of AIAN adults in 2018. It is also an essential source of revenue for the facilities and programs that make up the Indian Health Service (IHS) delivery system.

This brief provides an overview of the relationship between the federal government and AIAN people and provides a snapshot demographics, economic and health disparities, and access to health coverage and care for this population. It then describes the structure of the IHS (an agency within the U.S. Department of Health and Human Services), including eligibility criteria, delivery system characteristics, and financing sources. It goes on to detail the special Medicaid rules and protections that apply to AIAN beneficiaries and Indian health providers. Finally, it discusses some of the key policy issues affecting Medicaid’s relationship with the IHS and its role serving the AIAN population.

Publication Type: Issue Briefs