Ronnie Jo Horse: Keeping Our State’s Indigenous Communities Healthy | Columnists

The pandemic is hitting Indigenous people in Montana the hardest. Reservation borders have been rightfully closed by some tribes to protect their members from another virus threatening to devastate our communities. Unfortunately, the pandemic has exacerbated the high rates of unemployment and poverty already experienced by our communities.

Most people are unfamiliar with health care systems in Aboriginal communities. In addition to receiving a much lower number of services through IHS (Indian Health Services) on reservations, natives also have to travel farther for more specialized care, and then face not only the hassle of Medicaid, Medicare and the hospital billing, but also with the IHS system itself. Natives are often pushed — either by accident or through irresponsible billing practices — into massive medical debt.

Medical debt is the leading cause of bankruptcies in the United States, and Montana ranks 17th in the nation for unpaid medical debt. This debt also affects people of color more than their white counterparts. Add to that the fact that 43% of Natives are uninsured, and you have a recipe for debt and disaster that has nearly 27% of Montana’s Native community burdened with medical debt; compared to 13% of Montana’s white population.

Worse still, the means by which some people can pay off their medical debt – taking out loans, using a credit card, etc., which no one should have to do – are often inaccessible to natives due to their low incomes, unemployment and racial discrimination. discrimination in banking, credit and lending. This means that even a small medical debt, like a few hundred dollars, can be overwhelming for an Indigenous person and their family. Imagine what happens when the hospital bill you receive is close to $200,000 and someone is threatened with legal action if they cannot pay it immediately. Then imagine the anger and distrust you would feel towards the health care system when you find out that it was a hospital billing error that caused all the problems. This happened in Montana more often than you might think.

Natives are promised adequate health care and cost coverage by the US government. This promise is constantly broken by poor service coverage, lack of availability of services through IHS, and the efforts we must make to identify and access decent care. Western Native Voice, as an organization, fights tooth and nail to adopt policies such as the expansion of Medicaid – something that is supported by nearly two-thirds of Montanans – in order to open up access to health care. health for Montana natives. Simply put, the federal government needs to do something about toxic health care costs and billing practices so that aboriginal people don’t go into more debt and then get sued by hospitals, insurance companies and other collection agents. It must fulfill its legal and moral obligation towards the indigenous populations.

A recent poll shows that more than four in five voters (82%) agree that the amount they pay for health care is increasing every year. The majority of respondents also said they had trouble paying a medical bill at some point. While Montana residents err on the side of caution about major changes to the health care system in the near term, they are very clear that the continued expansion of Medicaid (63%) and the reduction in health care costs ( 49%) are necessary steps.

Native people in Montana need the state and federal government to fulfill their obligation to provide health care to the tribes. Whether through the permanent expansion of Medicaid or other means, there must be a concerted effort to reduce costs and ensure that Native people are not subjected to exorbitant medical bills and/or unfairly sued by hospitals and insurance companies. There is a need to ensure the health of indigenous communities in our state.