USET and other organization are asking for help lobbying for tribal consultation on the changes to Medicare and Medicaid funding to Indian country.  The rules have changed that leave it to State’s to set work requirements for eligibility for Medicaid funding through the 1115 waiver process.  This could severely impact Indian Health service funding.  Therefore AI/AN Medicaid recipients must be made exempt from these barriers to accessing the health care to which they are entitled, and CMS has a duty to ensure that this occurs as a part of the waiver process. Medicaid currently represents 67% of 3rd party revenue at IHS, and 13% of overall IHS spending.   Tribal organization are advocating that any proposed changes to the administration of Medicaid must be preceded by comprehensive consultation with Tribal Nations. Currently, the 1115 waiver process requires that states engaged in Tribal Consultation prior to submission of 1115 Demonstrations to CMS. CMS must ensure Tribal consultation with Tribal Nations occurs at both the state and federal levels before state waiver applications can proceed.

See USET Letter