mmpc - National Indian Health Board

Analysis of Tribal Consultation Policies For Health Insurance Exchanges
because significant issues are at stake, including mental health parity, limitation in
number of visits, and having a separate plan for pediatric oral and vision services.
Consultation for Partnerships in FFE
In summary, 13 of the 34 states with Tribes have an approach to Tribal Consultation for
Exchange planning. Among the other 21 states, 10 did not receive Establishment
Grants and are, therefore, not likely to have state Exchanges or Partnerships in the FFE
(including 6 that did not respond to the survey).
Both the I/T/U and the federal government should be most concerned about the States
that received Establishment Grants with the clear direction to engage in Tribal
consultation and for which there is no evidence that this has been done. These include:
Iowa, Massachusetts, Maine, Michigan, North Carolina, Nevada, and South Dakota.
Idaho also received an Establishment Grant, but did not respond to the survey.
A number of these States indicated that they are still evaluating their options and have
not made a decision about what they will be doing, in most cases waiting until after the
election. This seems to be a rationale for not engaging Tribes in the planning process
and not developing policies, such as a Tribal Consultation policy. However, if they have
been using their Establishment Grant funding to do planning, they are likely to submit a
Blueprint for partnership in the FFE. These States may assume FFE functions related
to plan management, or consumer assistance, or both. If the federal government
approves their Partnership applications, these States will be making decisions that
affect the I/T/U without necessary consultation.
Attachments:
A. Letter to Governors from Kathleen Sebelius, HHS Secretary, September 14, 2011
B. Status of Tribal Consultation Policies
C. Issues for Tribal Consultation
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