An extensive federal statute, the Indian Self-Determination and Education Assistance Act, 25 U.S.C. §§ 5301 et.seq., allows Indian tribes who elect “self-determination” to fund health care for their members using money supplied directly to the tribes by the Indian Health Service, the federal government’s agency for providing health care to Indians. In addition to that money, the Act requires the agency to reimburse “self-determination” tribes for the overhead and administrative expenses they incur in operating their own health care plans under the Act, expenses the federal agency itself does not have to pay on account of the administrative and overhead services available to the agency from other parts of the federal government. In Becerra v. San Carlos Apache Tribe, decided on June 6, 2024, the Court ruled that the Act required the Indian Health Service to reimburse “self-determination” tribes for the administrative and overhead expenses they incur when they use money they have received from Medicare, Medicaid, or third-party insurers to pay for health care services. The vote on the Court was five to four. In its majority decision, the Court claimed the literal language of the Act, and particularly the provisions of 25 U.S.C. §§ 5325 and 5326, required its decision. In the dissenting Opinion, the dissenters claimed the literal language of the Act, and particularly the provisions of 25 U.S.C. §§ 5325, 5326, and 5388, prohibited the majority’s decision. The majority decision will certainly cost the federal government more money. Chief Justice Roberts and Justices Gorsuch, Sotomayor, Kagan, and Jackson were in the majority. Justices Kavanaugh, Thomas, Alito, and Barrett dissented.
COMMENT: The Indian Self-Determination and Education Assistance Act is ambiguous on the issue of its coverage for tribe administrative and overhead expenses incurred in paying out health care benefits that are covered and paid for by third parties other than the Indian Health Service. The choice for the Court was selecting the reasonable interpretation of the statute that better served the statutory purpose of limiting the government’s financial liabilities, or the reasonable interpretation of the statute that better served the statutory purpose of assisting the descendants of native Americans. No Justice, however, admitted that this was the choice he or she was making in taking the side he or she took.
Dan Rhea
RECENT RULINGS 