The Affordable Care Act聽 new health coverage opportunities for more than half a million Native Americans and Alaska Natives 鈥� and jobs have followed on its coattails.
In Montana, this is playing out at the Blackfeet Community Hospital. It鈥檚 the only hospital on the Blackfeet reservation, and has been mostly funded 鈥� and chronically underfunded 鈥� by the , which has been in charge of Native American health care since its founding in the 1950s. But now, many Native Americans have been able to afford health insurance on the Obamacare exchange, and last year, Montana expanded Medicaid. Now, about one in seven reservation residents gets Medicaid.
Blackfeet Community Hospital needed to build an infrastructure to deal with the byzantine bureaucracy聽that comes with taking Medicaid and private insurance. The tribe鈥檚 community college started a new curriculum to help meet the growing demand for people in Indian country to process insurance claims.
Blackfeet tribal member Gerald Murray took the courses. 鈥淚 got a contract before I graduated in April, and then the day of graduation in May it became permanent so I applied for it,鈥� he聽said.
Murray鈥檚 experience is an example of the health care law鈥檚 transformative power in聽Native American communities, said Montana鈥檚 director of American Indian Health, .
鈥淭o me, there鈥檚 opportunity there to not only build health care, but to build your entire community and build jobs,鈥� said Billy-Old Coyote.
Unemployment on most of Montana鈥檚 Indian reservations is the rest of the state. And people who are working don鈥檛 always get health insurance with their jobs. So ACA subsidies that bring down the cost of insurance premiums are a big deal, Billy-Old Coyote said. Most Montanans, Native or not, can now get policies for about $75 a month. It is a big change for the reservation communities where people are accustomed聽to聽the underfunded IHS, which often didn鈥檛 pay for care unless someone was in immediate danger of losing life or limb.
(Courtesy of Mary Lynne Billy-Old Coyote)
鈥淣ow you鈥檝e got an opportunity for American Indian people to truly have access to private insurance,鈥� she said. 鈥淵ou have access to greater networks of providers and specialists, and all the things we generally don鈥檛 see you have access to.鈥�
Medicaid expansion had a lot to do with the number of health care jobs in Montana growing by 3聽percent last year, according to state statistics. And schools in Montana, including tribal colleges, are offering more classes in health care fields.
At Blackfeet Community College, 23-year-old Leroy Bearmedicine is working toward certification as an emergency medical technician.
鈥淚鈥檇 like to become a registered nurse at some point, maybe even work my way up to flight nurse 鈥� something to get the adrenaline going,鈥� he says.
Native American leaders have seen the Affordable Care Act as a means to remedy a series of broken promises by the federal government to care for them. They now fear that promise, too, will fade. One estimate suggests Montana will if the Affordable Care Act is repealed.
This story is part of a reporting partnership with NPR, Montana Public Radio and .