The COVID-19 pandemic disproportionately affected Tribal nations, which already operate with a severe lack of public health funding. The Indian Health Service (IHS) the largest source of healthcare in Indian Country, is typically funded at between 50% and 60% of need.1 IHS often runs out of money during the middle of the fiscal year, which can cause Tribal members to delay basic or serious medical services. 1
Additionally, access to healthcare in Indian Country is limited. The Commonwealth Fund reported that in some remote areas, there is one hospital for an area with 2.2 million Native Americans living on rural reservations2 or some tribes must travel via plane more than 500 miles to receive quality care. Due to a lack of funding and workers, the staffing at these facilities is typically 20% lower than what the IHS recommends. 2
Long before the pandemic, the health inequalities between American Indians and the rest of the United States population were massive. “American Indians are 50% more likely to have a substance use disorder, 60% more likely to commit suicide, twice as likely to smoke, twice as likely to die during childbirth, three times more likely to die from diabetes and five times more likely to die from tuberculosis. On average American Indians die five years sooner than other Americans. 3 ”
Tribal casinos are significantly associated with improved health-related community resources for Tribes.4 Many casinos on Native American land supplement chronically underfunded health and education programs and create countless jobs for Tribal members. According to the CDC, American Indian adults, living in a community with a casino have decreased rates of mortality, obesity, diabetes, smoking, and binge drinking, compared with living in a community without a casino.4 In California, data suggests that living in a community with a Native–owned casino was significantly associated with decreased childhood obesity and newborn large-for-gestational age. In North Carolina the opening of a casino in a community lead to more income among American Indian families and showed a decreased risk of some behavioral issues in childhood and of substance abuse in young adulthood.
However, nearly 1,000 casinos across the country have closed since the coronavirus hit the U.S., according to the American Gaming Association. Some fought to stay open longer so they could continue to provide health benefits to their respective Tribal members during a healthcare crisis. Now with the worst of the pandemic behind us ,the Tribal casinos that remain- are re-opening to the public but must make up for lost revenue.
Many Tribal casinos are looking for ways streamline expenses without cutting the quality of healthcare for their communities. Tribal Edge is a Native-owned brokerage firm that develops customized benefits solutions for Tribal enterprises focused on reinvesting savings into alternative benefits that are relevant to their Tribal member/employee population and community. Tribal Edge brokers pride themselves on becoming a community partner and strategic guide to help ensure your health plan savings promote health and wellness for Indian Country. The National brokerage firm offers innovative health plan model options, pharmacy benefits to lower prescription drug costs, ancillary benefits to attract and retain talent, recruiting and HR advisory services with a focus on the unique needs found within Indian Country. Tribal Edge has the tools and solutions to keep your Tribal business and Tribal community flourishing.
2- https://www.commonwealthfund.org/blog/2020/challenge-covid-19-and-american-indian-health
3- https://rollcall.com/2018/03/05/the-never-ending-crisis-at-the-indian-health-service/
4- https://www.cdc.gov/pcd/issues/2019/18_0252.htm