Wayne Wilson stands in a hogan at the Native American Baha’i Institute in Houck, Arizona, in 2022. He is holding eagle feathers that he uses in traditional healing ceremonies. Sweat lodging, music therapy and other traditional healing treatments could now be covered by Medicaid in four states, including Arizona. (File photo by Laura Bargfeld/Cronkite News)
PHOENIX – Native Americans in Arizona and three other states could now see government health coverage for some traditional healing practices.
On Oct. 16, the Biden administration announced it had expanded both Medicaid coverage and the Children’s Health Insurance Program (CHIP) in Arizona, California, New Mexico and Oregon to cover traditional Native American healing practices through demonstration amendments to section 1115 of the Social Security Act.
“Traditional health care practices have been a way of life in many communities. And they are extremely important for American Indian and Alaska Native populations,” Health and Human Services Secretary Xavier Becerra said in a news release. “But, too often, health insurance does not cover them. With Medicaid and CHIP’s inclusion of traditional health care practices at certain IHS facilities, we are extending access to culturally appropriate, quality health care in Tribal communities.”
In Arizona, traditional health-care practices received either through the Indian Health Service (IHS) or facilities independently operated by tribal nations are eligible for Medicaid and CHIP coverage.
Unlike California, New Mexico and Oregon, Medicaid coverage for Native American healing practices in Arizona will also extend to Urban Indian Organizations, which are nonprofit organizations that provide health care and other services to Native Americans and Native Alaskans.
Medicaid is government-run health insurance that offers low-cost or free coverage for low-income individuals in families in the U.S. CHIP works similarly but offers coverage specifically for children who are in families that fall outside of Medicaid eligibility but are not insured through a family plan.
Coverage for traditional healing practices will depend on the individual facility that a patient visits, but covered treatments could include sweat lodging and music therapy.
The Arizona Health Care Cost Containment System had originally submitted a request to cover these services in 2015 but that request was denied.
The Centers for Medicare & Medicaid Services (CMS) released a policy framework earlier this year for the four states that detailed how the amendments would ensure traditional healing practices are reimbursed at a 100% service match. Prior to the amendment, facilities that offered traditional healing practices were not reimbursed.
Arizona has long struggled to address health disparities for Native Americans in the state. The state has been plagued with fake rehab facilities that purposely targeted Native Americans. Recruiters for these facilities would often go out to Native American tribal lands or wait outside of health-care facilities for Native Americans, where they would lure people to sober living facilities that were often unsafe, provided inadequate care and defrauded Medicaid by billing the state’s American Indian Health Program for treatments that weren’t provided.
Last year, Arizona Attorney General Kris Mayes launched an investigation in tandem with the FBI and various tribal authorities to bring charges against these facilities.
Native Americans have also been disproportionately affected by higher rates of diabetes, cardiovascular disease and obesity. Substance abuse problems and suicide are also higher in Native Americans than other ethnic groups in the United States.
In 2022, the U.S. Department of Health and Human Services Office of Minority Health found that suicide was among the leading causes of death for young non-Hispanic American Indians and Alaska Natives between the ages of 10 and 34.
Ongoing and historical trauma perpetuated by the United States government has contributed to many of the health disparities faced by Native American communities.
Genocide, the forced relocation of hundreds of thousands of Native Americans from their homelands onto reservations with poor living conditions, the near-eradication of a primary food source of buffalo and introduction of unhealthy food rations, along with assimilatory boarding schools that ran until the 1970s, have left haunting generational trauma in many Native American families that have contributed to poor diets, substance abuse and physical and mental health problems found in these communities.
For decades, the federal government also barred many Native American communities from being able to practice traditional medicine.
Tribal leaders say the move could decrease health gaps for Native Americans by incorporating sacred healing practices that have been used and trusted for generations.
“This groundbreaking approval reflects the understanding that health is more than physical; it is spiritual, emotional, and deeply tied to our culture,” Navajo President Buu Nygren wrote in a recent post on the social media platform X. The Navajo Nation is the largest Native American tribal nation in the United States, with a land base as large as West Virginia. “Traditional healing — including ceremonies and treatments — will now be more accessible through hospitals, clinics, and tribal programs, providing holistic care for our people.”
Many traditional Native American healing practices have proven health benefits. Sweat lodges, for example, have been documented as being helpful in ridding infections from the body, helping with pain relief and rheumatic diseases like arthritis, alleviating insomnia and promoting healthy skin.
Sweat lodges hold spiritual significance with many Native American communities and can also help with detoxification – a rehab treatment that could help mitigate substance abuse problems within Native American communities.
“By strengthening access to traditional health care practices, these innovative state demonstrations can play a crucial role in reducing health disparities and improving health across tribal communities,” CMS Administrator Chiquita Brooks-LaSure said in a news release.
Phoenix Indian Medical Center (PIMC), IHS’ largest Indigenous care facility in the Phoenix metro area, provides direct health services to over 150,000 individuals.
PIMC offers spiritual care services, described on the website as “person-centered care provided to meet a suffering individual’s needs in the present moment.”
“PIMC is unique in that it is located in a major metropolitan area and serves a large patient population that is representative of more than 74% of the 574 federally recognized tribes,” wrote PIMC CEO Deb Ward Lund in a statement to Cronkite News. “The Centers for Medicare & Medicaid Services (CMS) coverage of traditional health care practice will support the growth of PIMC’s spiritual care program and we look forward to supporting the IHS in implementing this initiative across the agency.”
The spiritual care coverage isn’t permanent It’s part of a pilot program that will be reviewed for the next several years and is set to expire on Sept. 30, 2027, if not extended.
“American Indian and Alaska Natives have been endowed by our ancestors a deep and priceless wealth of traditional healing knowledge,” said IHS Director Roselyn Tso in a news release. Tso is an enrolled member of the Navajo Nation and is from LeChee, Arizona.
“These practices have sustained our people’s health for generations and continue to serve as a vital link between culture, science, and wellness in many of our communities,” she said.
