Cantwell Secures Promise From RFK Jr. to Work Toward 100% Federal Medicaid Reimbursement for Urban Indian Health Centers

Cantwell Secures Promise From RFK Jr. to Work Toward 100% Federal Medicaid Reimbursement for Urban Indian Health Centers

"You can call me directly on that," Sec. Kennedy assures Cantwell during Senate hearing

WASHINGTON, D.C. - Yesterday, U.S. Senator Maria Cantwell (D-WA), a senior member of the Senate Finance Committee and former chair and longtime member of the Senate Indian Affairs Committee, received a commitment from U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. to work toward her goal of securing a 100% Federal Medical Assistance Percentage (FMAP) for Urban Indian Health Programs (UIHPs) including the Seattle Indian Health Board and NATIVE Project in Spokane, WA.

"Indian urban health needs the full FMAP funding," Sen. Cantwell told Sec. Kennedy at a Finance Committee hearing. "We got a fix, myself and Senator Murkowski, but it only lasted for two years. And so, we would like to see Urban Indian Health get the full federal medical assistance for the Indian health care programs. And would you work with us on that?"

"Absolutely and enthusiastically," replied Sec. Kennedy. "And you can call me directly on that."

Indian Health Service facilities and tribally operated health care services already receive a 100% FMAP, meaning that the federal government reimburses them fully for Medicaid costs. However, Urban Indian Health Programs that serve the approximately 150,000 American Indians and Alaska Natives who live in urban areas only receive a 50% to 70% reimbursement.

Sen. Cantwell helped temporarily secure a 100% FMAP as part of the American Rescue Plan Act of 2021. With the full reimbursement, the Seattle Indian Health Board was able to invest in a new 92-bed inpatient addiction treatment and recovery facility. The NATIVE Project in Spokane invested in building a new Children and Youth Services Center that is set to open next month. Since that law expired in 2023, urban Indian health care providers have not received the cost savings from a 100% FMAP reimbursement.

Sen. Cantwell has been a leader on health issues facing tribal communities. In 2023, Sen. Cantwell called for and got a committee hearing on the devastating impacts of fentanyl in Indian Country. In 2024, she introduced the Purchased and Referred Care Improvement Act -- bipartisan legislation that makes it clear that the Indian Health Service (IHS) is responsible for paying medical bills for IHS beneficiaries, not tribal members.

Video of Sen. Cantwell's exchange with Sec. Kennedy is HERE. A transcript of the full exchange is below:

Sen. Cantwell: You talked a lot about Indian health care, which I appreciated. I've met with several tribes. One issue is that we don't have - for urban you know, IHS does their thing. You've addressed trying to fix that, but Indian urban health needs the full FMAP funding.

We got a fix, myself and Senator Murkowski, but it only lasted for two years. And so, we would like to see Urban Indian Health get the full federal medical assistance for the Indian health care programs. And would you work with us on that?

Sec. Kennedy: Absolutely and enthusiastically.

Sen. Cantwell: Okay, great. Second issue...

Sec. Kennedy: And you can call me directly on that.

Sen. Cantwell: Great. So appreciate that. This is a really big issue people don't understand, but we have 150,000 American Indians and Alaska Natives that live in urban areas like Seattle, and so when they only get half the money for the care that everybody else gets, it creates a disparity in actually being able to deliver that care.