American Indian Exceptionalism

Christopher Beam | Slate | September 18, 2012

The health care plan released by Senate Finance Committee Chairman Max Baucus on Wednesday includes a requirement that every nonsenior American either buy insurance or pay a fine. There are exceptions, however, for anyone below the poverty line, people who face extreme hardship, and American Indians. (Read the bill summary here.) Why are American Indians exempt?

Because they have their own health care system. The Indian Health Service, which operates under the Department of Health and Human Services and whose funding comes out of the federal government's annual budget, provides care to any person who is a member or descendant of one of the 560 federally recognized tribes. Because they're covered by IHS, Indians don't need to purchase private insurance. (Many do anyway—more on that later.)...

...Whereas the U.S. health care system spends about $6,000 per American, IHS spends only $2,100. American Indians are less healthy on the whole than other Americans. And CHS, whose money sometimes dries up midyear, is chronically underfunded. Hence the oft-quoted aphorism, "Don't get sick after June."