“Health Insurance Premium Tax Credit” (IRS REG-131491-10)

NIHB Supplemental Submission - Definition of IndianThe Snyder Act is the primary statute authorizing the Federal government to provide healthcare to Indians and implementing the unique Federal obligations to Indians. It directs andauthorizes HHS 53 to ―direct, supervise, and expend such moneys as Congress may from timeto time appropriate, for the benefit, care, and assistance of the Indians throughout the UnitedStates‖ for the ―relief of distress and conservation of health.‖ 54 The statute was enacted forthe ―special benefit of Indians and must be liberally construed in their favor.‖ 55Congress and Federal courts have affirmed that the Snyder Act implements theFederal government‘s trust obligation to Indians. For example, the House ofRepresentatives‘ report of April 9, 1976, published as part of the legislative history of theinitial version of the IHCIA, states that the Snyder Act‘s directive for the Federal governmentto provide ―for the relief of distress and conservation of the health of Indians‖ remains ―thebasic legislative statement of the Federal Government‘s obligation to provide health servicesto Indians.‖ 56 Courts have found that the Snyder Act was enacted out of the Federalgovernment‘s ―overriding duty of fairness when dealing with Indians, one founded upon arelationship of trust for the benefit of‖ AI/ANs. 57 Citing these principles, courts have heldthat IHCIA implements and expands on the Snyder Act. 58 In fact, when examining theIHCIA‘s gloss on the Snyder Act, one court was ―struck by Congress‘ recognition of federalresponsibility for Indian health care.‖ 59 Since ACA contains specific provisions for healthcare to Indians, including the permanent authorization of the IHCIA as well as specialtreatment in the Exchanges and other ACA programs, there is no basis to conclude that theACA does not also implement and expand on the Snyder Act.This understanding of the Snyder Act and its relationship to the IHCIA and otherFederal laws for the benefit of Indian health are critical to correctly implement the definitionsin the ACA. In an exchange regarding tribal concerns about how the proposed rules treat thedefinition of Indian, an HHS official commented that the regulations adopted by HHS to53The responsibilities under the Snyder Act were transferred to the Secretary of Health,Education, and Welfare (the precursor to HHS) pursuant to the Act of August 5, 1954, Pub. L. 83-538,commonly referred to as the Transfer Act.5455562653.5725 U.S.C. § 13.Wilson v. Watt, 703 F.2d 395, 402 (9th Cir. 1983).H.R. REP. No. 94-1026(I) (Conf. Rep.), at 2 (1976), reprinted in 1976 U.S.C.C.A.N. 2652,Fox v. Morton, 505 F.2d 254, 255 (9th Cir. 1974). Accord Blue Legs v. U.S. Bureau of IndianAffairs, 867 F.2d 1094, 100 (8th Cir. 1989).58See, e.g., McNabb for McNabb v. Heckler, 628 F. Supp. 544, 547 (D. Mont. 1986), aff’d, 829F.2d 787 (9th Cir. 1987). Accord Hornell Brewing Co., Inc. v. Brady, 819 F. Supp. 1227, 1236 n.9(E.D.N.Y. 1993) (noting, with approval, the emphasis placed on the Snyder Act‘s continuing viabilityin McNabb).59Malone v. Bureau of Indian Affairs, 38 F.3d 433, 438 (9th Cir. 1994); accord Zarr v. Barlow,800 F.2d 1484, 1493 (9th Cir. 1986). We note that the Malone court ultimately overturned the BIAregulations at issue for violations of the federal Administrative Procedure Act. This does not detractfrom or otherwise diminish the validity of the case‘s interpretation of the Snyder Act.National Indian Health Board Page 13 of 24 October 31, 2011