Northern Arapaho hail health care victory upholding sovereignty

Northern Arapaho tribal leaders Thursday celebrated a win in the U.S. Supreme Court in a lawsuit that sought a $1.5 million federal reimbursement for health care costs.

Tribal leaders said the decision upheld sovereignty rights for the Northern Arapaho and other tribes.

The 5-4 opinion filed Wednesday resolves a 2021 complaint the tribe brought in U.S. District Court claiming the federal Indian Health Service refused to appropriately cover costs the tribe incurred while operating federal health care programs on the Wind River Indian Reservation. At issue was whether the IHS is obligated to cover certain administrative costs the tribe incurred when it contracted for services with third parties.

“Indian Country is often forgotten and left out when it comes to allocation of health care dollars,” said Lee Spoonhunter, a member of the Northern Arapaho Business Council.

The case was a “unique tribal sovereignty fight,” he said. The IHS is “underfunded by a large gap” making local control important to effective service delivery.

“We’re able to assess our peoples’ problems,” he said, and use IHS funding “to provide a better system of care.”

In a debate involving language that might make a CPA weep (“IHS’s obligation to pay contract support costs is limited by Section 5326, but the limitations of that provision do not preclude payment of costs incurred by the required spend­ing of program income under a self-determination contract.”) the court agreed that the government shortchanged the tribe by about $1.5 million over two years.

Arcana aside, the Supreme Court landed on tribal rights enumerated in the 1975 Indian Self-Determination and Education Assistance Act.

“The Government argues that the tribes should not get contract support costs … because that would give them the flexibil­ity to spend such income on a broader range of activities than IHS can,” the opinion stated. “[T]he fact that the con­tracting tribe can act unilaterally in this regard is the nat­ural result of self-determination.”

Chief Justice John Roberts penned the 18-page opinion with associate justices Sonia Sotomayor, Elena Kagan, Neil M. Gorsuch and Ketanji Brown Jackson concurring.

Momentous

The Northern Arapaho Business Council hailed the “momentous victory” not only for its Wyoming members but for the sovereignty of all tribes.

“We are very happy to, and honored to, provide that fight and lead forward,” Councilman Spoonhunter said.

“This ruling upholds the promise of the Indian Self-Determination Act, which Congress passed with the intention of reimbursing tribes for their costs in administering health care programs,” the council said in a statement. “A judicial finding to the contrary would have cost our Tribe alone millions of dollars, leading to reduced services and programs that our community relies upon.”

The opposing parties agreed that the IHS was required to, and did, cover many administrative costs associated with tribal operation of health care services, which it performed through a local-control agreement with the federal agency. At issue was whether some third-party contract administrative costs were part of the IHS “program” or somehow separate and non-reimbursable.

“This is the first step in the right direction to bring health care to what it needs to be,” Spoonhunter said. “But also it shows we still have a long way to go.”

The U.S. District Court for Wyoming found against the Northern Arapaho in the first instance, but the tribe appealed to the U.S. 10th Circuit Court of Appeals. That body overturned the Wyoming-based decision.

The federal government appealed to the U.S. Supreme Court, which agreed to hear the case. Wind River Family & Community Health Care CEO Richard Brannon brought the issue to the tribe’s attention, the business council said.The Northern Arapaho tribe’s appeal was captioned Xavier Becerra, v. Northern Arapaho Tribe and was consolidated with Xavier Becerra, v. San Carlos Apache Tribe.