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Connecting American Indian & Alaska Native Children to Health Coverage

January 20, 2017

American Indian and Alaska Native (AI/AN) communities represent 2% of the total non-elderly population. However, AI/AN rank among the highest rates of uninsurance totaling 21% in 2015. That is nearly twice the rate for African Americans, and approximately 12% more than the rate of non-Hispanic whites.

AI/AN communities experience greater health disparities and higher mortality rates than other Americans and encounter barriers to health access due to remote geographic locations, lack of access to reliable Internet and phone service, distrust of government programs, language and health literacy barriers, and cultural differences. Even with the provisions that address the challenges to enrollment for AI/ANs, and despite reduced rates of uninsurance to their lowest levels in our nation's history with ACA enrollment efforts, additional work to enroll AI/AN individuals and improve health outcomes is needed.

The Campaign's recent webinar featured organizations dedicated to providing and connecting AI/AN children to health coverage. The panel shared their work engaging these communities in Medicaid and Children’s Health Insurance Program (CHIP) coverage and tools and resources for other organizations working with AI/AN populations.

Campaign in Action

The Division of Tribal Affairs at the Centers for Medicare & Medicaid Services works closely with AI/AN communities and leaders to assist with access to health care for those eligible for Medicaid and CHIP in Indian Country. CMS collaborates with the Indian Health Service and other federal partners to facilitate access to high quality, culturally competent, and timely health care. Resource offerings include a suite of customizable resources and a recently released Informational Bulletin that summarizes the relevant Indian provisions of the final Medicaid and the CHIP managed care regulation.

As the principal federal health care provider and advocate for AI/AN communities, the Indian Health Service (IHS) provides comprehensive health services through their system of area offices and tribally managed service units including urban programs and resource centers. Health services and referrals are provided directly by the IHS, through tribally contracted and operated health programs, and through services purchased from private providers. IHS focuses on outreach and enrollment during the renewal cycle, and they have seen marked results from their partnerships in the field. These success stories are posted on the IHS Blog and by the Tribal Self-Governance Advisory Committee.

The National Indian Health Board (NIHB) has found success using digital engagement strategies to spreading health information among young AI/AN children. They work with trusted messengers to share information about enrollment and to emphasize the benefits of Medicaid and CHIP. NIHB has developed outreach toolkits which contain best practices for engaging and enrolling youth in health coverage.

The Southcentral Foundation (SCF) implements multiple initiatives and partnerships to increase Medicaid and CHIP enrollment among rural American Indians and Alaska Native populations throughout Alaska. Their targeted local events and in-person assistance at rural health care clinics and other local service organizations including shelters and youth homes, allow them to identify and contact individuals prior to their appointments to connect them with enrollment information and assistance. These outreach efforts showed to be a success with more than half of the individuals provided information about Medicaid and CHIP submitting an application.

Oklahoma's Cherokee Nation Health Services Group (CN), a Connecting Kids to Coverage grantee, operates eight full service health centers and one inpatient hospital throughout its tribal jurisdictional service area. The organization works with their nationally accredited tribal public health department, WIC and dental programs, education, housing, community service and human service departments. CN also works directly in the communities with schools, newborn and pre-school children, and other families to help enroll children and families in Medicaid and CHIP.

In 2016 CN used resources from the Campaign's Get Covered. Get in the Game. strategy guide to create an advertising campaign. The campaign aired during University of Oklahoma football and basketball games and featured students sharing their stories about the importance of health coverage. The campaign even featured two halftime interviews conducted during big rivalry football games. CN tapped a peer group of local student athletes to produce materials.  These materials included billboards, print and broadcast ads, and social media. The television spot featured the students and their stories and airs on different stations in NE Oklahoma and on the tribe's television network.

Stay Connected with the Campaign

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