The Northern Arapaho Tribe has announced it will no longer use the Federal Employee Health Benefits Program but instead will self-insure tribal employees in hopes of moving toward greater tribal sovereignty. Last year, the tribe took over the management of their health clinics, too.
Matt Silverstein is CEO of First Nation Health Insurance, the company that would help set up the program. He said they're already serving the Eastern Shoshone and that tribe has self-insured its members for several years. He said many tribes are moving toward self-insuring.
“All the tribes across the country that any tribal member thinks of as successful or well operated, all of them have a self-funded program,” he said.
He says only three in ten Arapaho employees are participating in the federal insurance, one of the lowest rates in the country.
“By contrast, the Eastern Shoshone Tribe has more than twice as high of participation rates by their employees and they’re paying a fraction of what the Arapaho are paying.”
Northern Arapaho member Andrea Clifford is the former assistant manager of the Wind River Casino. She said the tribe shouldn’t rush into this. In 2008, she said the casino tried self-insuring its employees under a law that says Medicare-qualified health care providers must offer Medicare-like rates to Native Americans. But she said the casino ended up in court with private providers.
“Even though you’re going to the hospital for let’s say an MRI, I mean, you get billed for the radiologist portion of that and they’re private and so we got pushback from them and they said no, the law doesn’t apply to us.”
Clifford said First Nation Health hasn’t put together a foolproof plan for how to overcome all these hurdles. She said her tribe needs to slow down and get more public input, especially from health program directors on Wind River.
“Maybe six months down the road or maybe next year? Maybe? But I think they still have a lot of groundwork to be doing,” Clifford said.
Meanwhile, the Northern Arapaho Business Council has announced they plan to start self-insuring in April.