House Natural Resources Committee Chair Introduces the Urban Indian Health Confer Act

WASHINGTON, D.C. – House Natural Resources Committee Chair Raúl M. Grijalva (D-AZ) recently introduced the bipartisan Urban Indian Health Confer Act to require the U.S. Department of Health and Human Services (HHS) to confer with urban Indian organizations (UIOs) on healthcare policies and initiatives for American Indians and Alaska Natives living in urban areas. Currently, only the Indian Health Service (IHS) is required to confer with UIOs despite the fact that the vast majority of American Indians and Alaska Natives – roughly 70 percent – live and seek healthcare in urban areas outside of IHS jurisdictions.

While IHS is the primary healthcare provider for those receiving care within tribal jurisdictions, UIOs are a critical part of the healthcare system that serves the citizens of 574 federally recognized American Indian and Alaska Native tribes across the country. The absence of a legal requirement for HHS to confer with UIOs on healthcare-related policies has exacerbated already severe inequities in healthcare access and healthcare quality for Native Americans around the country.

American Indians and Alaska Natives experience far worse health outcomes than other Americans, including higher rates of chronic disease such as diabetes and liver disease.

During the ongoing COVID-19 pandemic, HHS did not make UIOs aware of the need to weigh in on the Department’s vaccine rollout plan until the day of the deadline, despite congressional and tribal support for UIOs being included early in the process. As a result, vaccine distribution for many urban American Indians and Alaska Natives was significantly delayed.

“Urban Indian health organizations are a lifeline for hundreds of thousands of American Indians and Alaska Natives each year, and they need a role in federal health planning that reflects the seriousness of that responsibility,” said Grijalva. “I’m proud that the Urban Indian Health Confer Act will give UIOs the equal footing they always should have had in federal decision-making. Our federal trust responsibility demands nothing less.”

The bill is cosponsored by Reps. Betty McCollum (D-MN), Tom Cole (R-OK), Karen Bass (D-CA), Eleanor Holmes Norton (D-D.C.), and Rep. Don Young (R-AK). The bill is endorsed by the National Council of Urban Indian Health.

“Agencies have been operating as if only IHS has a trust obligation to American Indians and Alaska Natives, and that causes an undue burden to IHS to be in all conversations regarding Indian Country in order to talk with agencies,” said Francys Crevier (Algonquin), CEO of the National Council of Urban Indian Health. “It is imperative that UIOs have avenues for direct communication with agencies charged with overseeing the health of their American Indian and Alaska Native patients, especially during the present health crisis.”