A group of senators today pushed back against a Trump administration plan that could require Native Americans to find jobs to keep their Medicaid coverage, warning against "potentially devastating" ramifications for tribes’ access to care.
The growing fight over Native Americans’ health care, detailed in a recent POLITICO report, centers on tribes’ request to be exempted from new Medicaid work rules being introduced in several states, citing Native Americans’ status as separate government.
The Trump administration is failing “to recognize the unique legal status of Indian tribes and their members under federal law, the U.S. Constitution, treaties, and the federal trust relationship,” 10 senators — led by Sen. Tom Udall (D-N.M.) — wrote HHS Secretary Alex Azar. Sen. Lisa Murkowski (R-Alaska) was the only Republican to sign the letter.
The Trump administration has rejected the tribes‘ request, telling them in January that they were seeking an illegal racial preference.
“HHS believes that such an exemption would raise constitutional and federal civil rights law concerns,” an HHS spokesperson told POLITICO last week. The department did not immediately respond to a request for comment on the senators’ letter.
The senators said there’s longstanding legal precedent that established Native American tribes as separate governments.
“[F]ederal classifications fulfilling federal obligations to Indians are not based on race but instead on a political relationship between the tribes and the federal government,” they wrote.
The senators also asked the administration to share the documents explaining why Native Americans would be subject to Medicaid work requirements, which HHS has yet to publicly produce despite requests from the tribes and POLITICO.