Supreme Court Victory for Tribal Healthcare Regarding Fair Funding for Contract Support Costs

Supreme Court Victory for Tribal Healthcare Regarding Fair Funding for Contract Support Costs

The Supreme Court has ruled in the case BECERRA, SECRETARY OF HEALTH AND HUMAN SERVICES, ET AL. v. SAN CARLOS APACHE TRIBE that the Indian Health Service (IHS) must pay our tribes for contract support costs when we, as tribal members, manage our own healthcare programs. This decision ensures fair funding and empowers us, supporting our tribal sovereignty.

When we run healthcare programs through self-determination contracts, we can collect funds from Medicare, Medicaid, and other third-party sources. However, running these programs comes with additional costs that IHS does not incur, such as administrative and overhead expenses. These are called contract support costs.

The Indian Self-Determination and Education Assistance Act allows us to take control of our healthcare services. This act is meant to support our self-determination and sovereignty. However, managing these programs is expensive. We must cover staff salaries, office supplies, and other necessary expenses. These costs are vital to ensure high-quality care.

Before this ruling, we were not always reimbursed for these extra costs. We had to use our funds or reduce services to cover expenses, which was unfair and went against the principle of self-determination.


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The Supreme Court’s decision changes this. Now, IHS must reimburse us for the contract support costs of running healthcare programs. This ensures that we have the resources needed to provide quality healthcare without facing financial hardship.

This ruling is crucial for all of us. It means better healthcare services and more control over providing them. It supports the idea that we should have the power to manage our own programs and be reimbursed fairly for the additional costs incurred.

Together with No. 23–253, Becerra v. Northern Arapaho Tribe, on certiorari to the United States Court of Appeals for the Tenth Circuit, we thank the justices: Chief Justice John Roberts, Justice Sonia Sotomayor, Justice Elena Kagan, Justice Neil Gorsuch, and Justice Ketanji Brown Jackson.

Today’s Supreme Court ruling in BECERRA v. SAN CARLOS APACHE TRIBE is a significant step toward fair funding and our tribal sovereignty. We should not face financial penalties for managing our healthcare programs. This decision ensures we won’t have to. It is a victory for justice and self-determination.


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