Photo: Replica of a Drypainting (Iikaah) after a drypainting by Tsi-tcaci, a hide picture of a dry painting pattern used in Navajo healing ceremonies, photo by John L Severance Fund, Cleveland Art Museum, Wikimedia Commons
by Kenneth G. White Jr.
In the late 1980’s and 90’s, there was a time in the State of Arizona where Native people were being blatantly discriminated against by politicians loyal to themselves and then Governor Evan Mecham. Times are the same now in many ways.
I was working for the Arizona Health Care Cost Containment System (AHCCCS) as the legislative liaison for Arizona Indian Tribes in Arizona. It was a great job, but there were some very crucial unresolved ongoing decision points for our dear native people (For those not familiar, AHCCCS is basically Medicaid).
The issue at the time was whether to include Arizona Indian Tribes in the new AHCCCS 1115 demonstration project being reviewed and approved statewide by the Arizona State Legislature.
Anti Indian factions took the arbitrary uninformed position that Native Tribes in Arizona had the Indian Health Service available for health care, and therefore, the State of Arizona was not legally or financially responsible for health care to tribal members living “on reservation” in Arizona.
Pro Indian factions took the definitive and informed position that Medicaid was an entitlement program by federal law, and therefore, Arizona Indian Tribes and citizens were entitled to such care, similar to any other citizen of the State of Arizona.
During this critical time there were only two native senators in the Arizona State legislature – one of whom was Mr. Jack C. Jackson Sr., from the great Dine’ Nation. Amidst political posturing, tactics, strategies and stupidity to intentionally leave native people out of AHCCCS health care coverage, Mr. Jackson stood firm in his official capacity as an elected official and Dine’ leader stating that native people were entitled to AHCCCS health care coverage as citizens of the State of Arizona.
During this crucial time, the State of Arizona held many meetings among the Governor’s Office and the Republican caucus to prevent native participation in AHCCCS. Rather than negotiating in good faith, or facilitating agreement between the State and Tribal Nations, the State hired a team of lawyers to seek ways to absolve their legal and financial responsibility to native people, and intentionally leave our dear people out of AHCCCS coverage.
As always, the critical factor was money. The State did not want to pay the state match of 32% to receive the remaining 68% from the federal government to fund the “on reservation” AHCCCS coverage. Total AHCCCS funding was in the millions of dollars when combining the total state and federal matching funds in the 1115 waiver. Millions of Arizona citizens would benefit, but not native people, if they had their way.
A standard approved funding formula was used nationwide by the Center for Medicaid and Medicare Services (CMS) for Medicaid service development. Rather than agreeing to this funding formula, the Arizona legislature took a racist position - based on your native race and where you live in Arizona, we politicians are deciding for you that you cannot receive AHCCCS health care. I remember sitting in the State legislature when one republican state senator took the floor and shouted, “Why should we pay for them damn Indians health care.” There was actually applause from some elected officials on the floor and people in the gallery.
As a Dine’ leader, Mr. Jackson was clearly outnumbered by fellow senators. The Governor’s Office and the Republican controlled state legislature clearly opposed his position for the people. The Governor had previously appointed the AHCCCS director, a republican also. His appointment was clearly meant to stack the deck against Native people, not only legislatively and legally, but also administratively, by appointing a fellow Republican to head AHCCCS.
Mr. Jackson continued to stand up for what was right and advocate for Native people despite the odds. We had a great professional relationship, were related by clan, and most of the time talked about things other than AHCCCS and politics. Rodeo, basketball and Native American Church were our topics. He had a great sense of humor and would tease me big time in a friendly manner. I looked up to him, respected him and supported him the best I could in day-to-day tasks and strategies. Through our interactions on AHCCCS, we decided - if the Republicans can strategize, so could we. Although I worked for AHCCCS and the State of Arizona at the time, I was a Dine’ in my heart, mind and soul. Through prayer and discussions, Mr. Jackson and I came up with a plan to present a realistic solution.
We identified and engaged our powerful constituents – the 22 Arizona Indian Tribes. We identified our legal foundation – 42 CFR which clearly states Medicaid is an entitlement program for eligible people, regardless of ethnicity or residential location. We identified the Indian Self-Determination and Education Assistance Act (P.L. 93-638) and the Indian Health Care Improvement Act (P.L. 94-437) as the federal laws and foundation of Tribes nationwide. These federal cornerstones of Indian law had much more legal authority, flexibility, and clout than a state legislative governing body.
Go to indigenousnetwork.org to read the full story.
