September 30, 2015 |  Issue 15-25
Tribal Self-Governance Advisory Committee Meeting
October 6-7, 2015
Washington, DC
Direct Service Tribes Quarterly Meeting
November 4-5, 2015
Oklahoma City, OK
Medicare, Medicaid Policy Committee Meeting
November 17, 2015
Washington DC
Tribal Technical Advisory Group Meeting
November 18-19, 2015
Washington, DC
Secretary's Tribal Advisory Committee Meeting
December 1-2, 2015
Washington, DC 

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In This Issue

In this week's Washington Report: NIHB Annual Consumer Conference was a success. 

There is information about what a Continuing Resolution in Congress means for Indian Country and current debates in Congress about The Affordable Care Act. Tribal Leaders have been updated on changes for the Special Diabetes Program for Indians. South Dakota might follow 31 other states by expanding Medicaid. NIHB is preparing for the Affordable Care Act Open Enrollment Period. 

NIHB Updates
Thank you for helping to make the Annual Consumer Conference a Success!
Thank you to everyone who helped make the National Indian Health Board's 32nd Annual Consumer Conference a success!  With over 500 attendees and dozens of speakers, we are so appreciative of all those who contributed to this important event.
Highlights of the conference included remarks from top-level government officials including US Senator Heidi Heitkamp (D-ND); US Representative Tom Cole (R-OK); Secretary of the Department of Health and Human Services Sylvia Mathews Burwell; and Secretary of Veterans' Affairs Robert McDonald.  All of these speakers made sure to acknowledge their commitment to working with Tribes and their desire to advance native health issues.
Attendees also had an opportunity to participate in a "World Café" on the Tribal Behavioral Health Agenda and hear updates on key policy and legislative issues including Medicaid Expansion; the Affordable Care Act implementation; and the use of mid-level dental providers by Tribes.  Our Native Youth Digital Storytelling event on Capitol Hill also gave attendees an opportunity to hear from our fabulous youth.  We also had the distinct privilege of honoring the top achievers in Indian health at our Native Health Awards Gala. 
Please continue to check for more information on the conference including speaker presentations and photos.  

NIHB Executive Director Stacy Bohlen and NIHB Chairman Lester Secatero congratulate 
Mim Dixon on recieving the Jake White Crow Award at Wednesday's Awards Gala. 
Capitol Hill Updates
Congress Likely to Pass Short-term Funding Extension for FY 2016
With the surprise resignation of House Speaker John Boehner (R-OH) last week, it is expected that Congress will pass a short-term funding measure, known as a "continuing resolution" or "CR," to keep the federal government funded until December 11, 2015.   Many conservative Members of Congress have argued for the stopgap measure to exclude funding for Planned Parenthood after a series of videos was released that allegedly show the organization illegally profiting from the sale of tissue from aborted fetuses. However, as of the time of this writing, it looks like efforts to derail the funding measure over the issue will not be successful.  Congress is expected to clear the CR sometime on Wednesday, September 30, just hours before the end of the fiscal year.
If Congress does pass the CR, Congress must finalize the rest of FY 2016 appropriations by December 11.  Many in Congress, on both sides of the aisle, are calling for a compromise that can raise the "caps" on spending set forth in the Budget Control Act of 2011.  Without an agreement on higher spending levels, there could be the risk of devastating across-the-board sequestration cuts.  Legislation has been introduced in both the House and the Senate to exempt Tribes from sequestration.  You can click here to learn more about these bills.

House to Advance Measure to Repeal Certain Parts of the Affordable Care Act
This week, three House Committees are considering legislation to repeal certain parts of the Affordable Care Act (ACA) through a fast-track process known as "reconciliation."  This will mean that the legislation is not subject to a filibuster in the Senate.  A similar process was used to pass parts of the Affordable Care Act in 2010.
Provisions that would be repealed under this law include the individual mandate requiring all individuals to have health insurance and the employer mandate which requires that employers offer coverage or pay fines.  Other provisions to be repealed in the proposal include ending a tax on medical devices and on high-cost insurance plans and repealing the Prevention and Public Health Fund.  The Indian Health Care Improvement Act which was passed as part of the ACA, is not part of this repeal effort.
President Obama will not sign this legislation into law if it reaches his desk. This represents a chance for the Republican conference to vote against "Obamacare." 
Administration Updates
Tribal Leaders Briefed on Changes to the FY2016 Special Diabetes Program for Indians
The Tribal Leaders Diabetes Committee (TLDC) convened for a quarterly meeting on September 24-25, 2015 in Washington DC.  In attendance were Tribal leaders representing the 12 Indian Health Service (IHS) Areas, the IHS Deputy Director Robert McSwain and leaders from the IHS Division of Diabetes Treatment and Prevention.

The TLDC was presented with details on the Special Diabetes Program for Indians Funding Distribution changes for FY2016 as outlined in the Dear Tribal Leader Letter from Mr. McSwain dated June 29, 2015.   Due to the merging of the Healthy Heart and Diabetes Prevention Initiatives into the Community-Directed (C-D) Grant Program, the C-D program will be increased by $21.3 million, the Urban C-D will increase by $1 million, funding for SDPI Program Support will decrease $2.1 million, and funding for Data Infrastructure Support will remain the same at $5.2 million. 

Due to the funding distribution changes and the use of more current data in the funding formula, all IHS Areas will receive an increase in funding.  The amount of funding distributed to the grantees is decided at the Area level.  Once the grant review process is complete and grantees identified, the Area offices will be reaching a consensus with the grantees on the Area funding formula, which data to use in the Area formula and any Area set-asides to determine the exact amounts each grantee will receive.

The competitive application process for the C-D program is currently underway.It is open to all federally-recognized Tribes rather than just current recipients; first time since 1998.  All information regarding the C-D grant program can be found at

South Dakota Seeks to Expand Medicaid
South Dakota may follow 31 other states and the District of Columbia by expanding Medicaid coverage to low-income families. Governor Dennis Daugaard met with Health and Human Services Secretary (HHS) Sylvia Burwell on Tuesday, September 29, 2015 to discuss the state's Medicaid expansion plan.  

South Dakota is looking for flexibility in expanding the Federal Medical Assistance Percentage (FMAP) to provide services to American Indians at 100 percent federal funding who are eligible for Medicaid but do not receive their health care from an Indian Health Service (IHS) provider.  Currently, when Tribal members are eligible for both IHS and Medicaid and receive their services from IHS, the federal government pays 100 percent of the costs. If the Tribal member is eligible for Medicaid and receives their services from a non-IHS provider, the state and federal government split the costs of the bill. Under the proposal, increasing access to non-IHS funded services through Medicaid at 100% federal funds would lead to state funds being utilized to offset the costs of expanding Medicaid.
In 2014, the Medicaid program in South Dakota paid $133 million for non-IHS services provided to American Indians. This proposal would save South Dakota millions of dollars, funds that could be used to expand Medicaid and add an additional 13,000 American Indians to Medicaid coverage. 
The Centers for Medicare and Medicaid Services (CMS) is also considering a similar FMAP Expansion proposal from Alaska and is currently inviting feedback from Tribes and States on changing its FMAP policy.  For more information on FMAP expansion, please contact Devin Delrow, Director of Federal Relations at
or (202) 507-4072.
NIHB is Getting Ready for the 2016 ACA Open Enrollment Period
In the coming weeks, the National Indian Health Outreach & Education Partners (NIHOE) will be joining the rest of the nation in preparation for the third open enrollment period under the Affordable Care Act (ACA). This will provide Americans with an opportunity to enroll in a new marketplace insurance plan or change their existing marketplace health coverage for 2016. The Open Enrollment period takes place November 1, 2015 to January 31, 2016. Here are some important dates regarding enrollment and plan activation.
  • November 1, 2015: Open Enrollment starts - first day individuals and families can enroll in a 2016 Marketplace plan. Coverage can start as early as January 1, 2016. This applies to both Federally-facilitated and State-based Marketplaces. Note: 2016 plans and prices will be available for preview the third week of October 2015.
  • December 15, 2015: Last day to enroll in or change plans for coverage to start January 1, 2016.
  • January 1, 2016: 2016 coverage starts for those who enroll in or change plans from November 1, 2015 to December 15, 2015.
  • January 15, 2016: Last day to enroll in or change plans for new coverage to start February 1, 2016.
  • February 1, 2016: 2016 coverage starts for those who enroll in or change plans from December 16, 2015 to January 15, 2016.
  • January 31, 2016: 2016 Open Enrollment ends - Last day to enroll in or change plans for coverage in 2016. Exceptions are made for those who qualify for a Special Enrollment Period.
  • March 1, 2016: 2016 coverage starts for those who enroll in or change plans from January 16, 2016 to January 31, 2016.
Note: American Indians and Alaska Natives (AI/AN) can enroll in the Marketplace, Medicaid and CHIP programs all year round
Note: Individuals who qualify for a Special Enrollment Period must register for Marketplace coverage within 60 days of their Qualifying Life Event.

NIHB will continue our ACA outreach and education efforts in Indian Country in order to increase coverage among American Indians and Alaskan Natives and provide individuals with options to access quality care. If you would like more information on our activities and how we can assist you and/or your Tribal community please, contact Dawn Coley at or Jason Curley at

910 Pennsylvania Avenue, SE
Washington, DC 20003
Main Phone: 202-507-4070
Fax: 202-507-4071
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