Medicaid Now Covers Native American Traditional Healing Practices in Arizona

On October 16, 2023, the Biden administration announced an expansion of Medicaid and the Children’s Health Insurance Program (CHIP) to include coverage for traditional Native American healing practices in Arizona, California, New Mexico, and Oregon. This expansion aims to make these culturally significant practices more accessible, recognizing their importance for the health and well-being of Native American communities.

Health and Human Services Secretary Xavier Becerra emphasized the significance of traditional health care in many American Indian and Alaska Native communities, stating that while these practices have long been part of their way of life, they have often been excluded from insurance coverage. The inclusion of traditional healing methods in Medicaid and CHIP will help address disparities in health care access, particularly in tribal communities.

In Arizona, this expanded coverage applies to traditional health-care practices provided through both the Indian Health Service (IHS) and facilities independently operated by tribal nations. Notably, Arizona will also extend this coverage to Urban Indian Organizations—nonprofit groups that offer health services to Native American and Native Alaskan populations in urban areas, unlike California, New Mexico, and Oregon.

Traditional healing practices covered under this expansion may include sweat lodges, music therapy, and other culturally significant treatments provided at designated IHS facilities. These therapies, deeply rooted in Native American traditions, are known for their potential health benefits, such as pain relief, detoxification, and promoting overall wellness.

The Arizona Health Care Cost Containment System initially requested Medicaid coverage for these services in 2015, but the request was denied. However, following the Centers for Medicare & Medicaid Services’ new policy framework for these four states, these services will now be reimbursed at a 100% service match. This policy change reflects a major step toward addressing health disparities faced by Native Americans, particularly those related to chronic conditions like diabetes, obesity, and cardiovascular diseases.

Arizona has struggled with health disparities for Native Americans, compounded by fraudulent rehab facilities that targeted this population. These facilities defrauded Medicaid and provided inadequate care. In response, Arizona’s Attorney General, in collaboration with the FBI and tribal authorities, launched an investigation to combat these practices.

Native Americans have historically faced higher rates of health issues, including diabetes, substance abuse, and mental health struggles, exacerbated by historical trauma and forced relocation. The incorporation of traditional healing practices into Medicaid and CHIP coverage is seen as an effort to address these disparities and promote holistic care that is culturally sensitive and effective.

Tribal leaders have welcomed this expansion, seeing it as a way to reduce health gaps and provide a more comprehensive approach to wellness that includes spiritual, emotional, and cultural aspects of healing. Navajo Nation President Buu Nygren praised the initiative, highlighting how traditional healing practices will now be more accessible through hospitals, clinics, and tribal programs, offering holistic care for tribal members.

Research has shown that many traditional Native American healing practices, like sweat lodges, have proven benefits. Sweat lodges are known to help with detoxification, pain relief, and skin health, and they hold spiritual significance in many tribes. These practices also provide potential solutions for tackling substance abuse problems, offering a more culturally relevant and effective alternative to traditional rehabilitation methods.

The expansion of Medicaid and CHIP to include traditional healing practices is part of a pilot program set to expire on September 30, 2027, unless extended. During this time, the program will be reviewed to assess its impact on health outcomes and its ability to reduce health disparities in Native American communities. The Indian Health Service (IHS) has expressed its support for this initiative, with facilities like the Phoenix Indian Medical Center (PIMC) anticipating growth in their spiritual care programs.

IHS Director Roselyn Tso, an enrolled member of the Navajo Nation, expressed pride in the new coverage, noting that traditional healing practices have long been a source of strength for Native American communities. She emphasized the deep cultural and scientific connection these practices offer to wellness, a connection that will now be more accessible to those in need.

This new policy marks a significant step in the ongoing effort to bridge health care gaps for Native Americans and is seen as a crucial move toward integrating traditional and modern medical practices for the benefit of tribal communities.

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