Becerra v. San Carlos Apache Tribe

Last updated

Becerra v. San Carlos Apache Tribe
Seal of the United States Supreme Court.svg
Argued March 25, 2024
Decided June 6, 2024
Full case nameBecerra, Secretary of Health and Human Services, et al. v. San Carlos Apache Tribe
Docket no. 23–250
Citations602 U.S. ___ ( more )
143 S.Ct. 1804, 216 L. Ed. 2d 540
Argument Oral argument
Holding
The IHS must pay "contract support costs” not only to support IHS-funded activities, but also to support the tribe's expenditure of income collected from third parties.
Court membership
Chief Justice
John Roberts
Associate Justices
Clarence Thomas  · Samuel Alito
Sonia Sotomayor  · Elena Kagan
Neil Gorsuch  · Brett Kavanaugh
Amy Coney Barrett  · Ketanji Brown Jackson
Case opinions
MajorityRoberts, joined by Sotomayor, Kagan, Gorsuch, Jackson
DissentKavanaugh, joined by Thomas, Alito, Barrett
Laws applied
Indian Self-Determination and Education Assistance Act

Becerra v. San Carlos Apache Tribe, 602 U.S. ___ (2024), was a United States Supreme Court case which determined that the federal government must provide additional funding to cover some third-party administrative costs incurred by Native American tribes that operate their own health-care programs.

Contents

Background

The Indian Self-Determination and Education Assistance Act (ISDA) provides Native Tribes the option to enter into a "self-determination contract" with the Indian Health Service to run their own healthcare programs that the IHS would have otherwise managed on its own. [1] If this option is chosen by a tribe, the IHS provides the tribe with the same amount of money to run these programs as the IHS would have spent if it were to be administered by the IHS itself. Additionally, the Tribe may collect money from outside programs such as Medicare, Medicaid, and private insurers. [2] [3] The overhead and administrative costs that the Tribe must pay to run these services, known as "contract support costs", and which the IHS avoids, are therefore reimbursed by the IHS. Two tribes, the San Carlos Apache Tribe and the Northern Arapaho tribe filed separate suits alleging the IHS did not reimburse costs incurred in collecting income from third-party revenue streams. [4] The Tribes contended that the IHS must, in addition to reimbursing the costs of typical IHS programs, also reimburse the tribes for the costs incurred when spending the money from private insurers on their healthcare programs. [5] [6] The Tribes subsequently sued the U.S. Department of Health and Human Services, IHS, and the United States, regarding the healthcare costs for the years of 2011–2013. [7] The District Court of Arizona and District Court of Wyoming dismissed the claims for reimbursement of third-party-revenue-funded portions of Native healthcare of the respective Tribes, resulting in the Tribes appeal. Following the appeal, the Ninth Circuit and Tenth Circuit Court of Appeals issued respective reversals of the district courts in favor of the Tribes. These rulings contrasted that of a 2021 ruling by the D.C. Court of Appeals that determined the IHS was not required to provide reimbursement thus generating a circuit split. Following this, the U.S. Government appealed the consolidated cases to the Supreme Court for hearing. [8] [9]

Supreme Court

Oral Arguments

Oral arguments were heard on March 25, 2024, with the Tribes represented by Adam Unikowsky, who represented the Northern Arapaho Tribe, and Sidley Austin, who represented the San Carlos Apache tribe. Unikowsky argued that the costs and reimbursements of the third-party revenue streams were in line with the goal of the tribes providing and managing their own health care, stating that "Ruling in the tribe's favor would further the purposes of the ISDA by promoting tribal self-determination and ensuring that adequate resources are available for health care in chronically-underserved communities". [10] Additionally, Unikowsky emphasized that the nature of the IHS harmonized with the purpose of the legislation, noting that "Such costs are recoverable if they're incurred in connection with the operation of the federal program function, service or activity pursuant to the contract. The disputed costs in this case meet that description”. [11]

Caroline A. Flynn of the Department of Justice represented the U.S. government, arguing that the use of reimbursement as described by the tribes was incongruent with prior allocation under the law. In addition, Flynn noted that applying 3rd party payments under IHS reimbursement jurisdiction could take funds from tribes working directly with the IHS and create a budgetary shortfall resulting in cuts to other vital IHS-provided programs, as the total IHS funding stood at $8 billion while contract support cost prior to such an expansion in reimbursement stood at roughly $1 billion. [12] [13] In contrasting the Tribe's arguments that the reimbursements were natural expectations for the IHS, Flynn contended that "What the tribes are arguing here is that [ISDA] also obligates IHS to subsidize the tribes' expenditures of funds that they don't receive from IHS under the contract. but rather collect from third parties as supplemental revenue. Statutory text and context refute that theory, which would upend how the statute has been administered for thirty-five years". [11]

Majority

Writing for the Majority, Chief Justice John Roberts, joined by Justices Sotomayor, Kagan, Gorsuch, and Jackson affirmed the argument by the tribes that 3rd party revenue streams were subject to reimbursement by the IHS. [14] [15] In his opinion, Roberts contended that the arguments of the government were inconsistent with the text and purpose of the ISDA as the ISDA was intended to provide an "effective voice in the planning and implementation of programs responsive to the true needs of their communities”, and noted that the potential of IHS not covering contract costs of outside programs would result in "a penalty on tribes for opting in favor of greater self-determination". [16] [17] [18] Additionally, Roberts noted that the covering of costs was necessary to prevent a funding gap between the tribes and the federal government, stating that "if IHS does not cover those costs to support a tribe's expenditure of program income, the tribe would have to divert some program income to pay such costs, or it would have to pay them out of its own pocket [...] Either way, the tribe would face a systemic funding shortfall relative to IHS—a penalty for pursuing self-determination". [19] [20]

Dissent

Justice Brett Kavanaugh wrote the dissenting opinion joined by Justices Thomas, Alito, and Barrett. In his opinion, Kavanaugh countered the majority's reading of the ISDA, stipulating that the law did "not support the Court's decision" and that the decision was at odds with a long-standing understanding of payment, stating "For the past 30 years, the Executive Branch has interpreted the relevant statutory provisions […] to require tribes to pay those overhead costs out of the third-party income […] And Congress has never overturned that consistent Executive Branch practice". [21] [22] [23] In addition, Kavanaugh commented that reimbursement by the IHS, had it been included, should have been specified via further deliberations of Congress, noting that "The extra federal money that the Court today green-lights does not come free". [24]

Related Research Articles

<span class="mw-page-title-main">Tribal sovereignty in the United States</span> Type of political status of Native Americans

Tribal sovereignty in the United States is the concept of the inherent authority of Indigenous tribes to govern themselves within the borders of the United States.

<span class="mw-page-title-main">Indian Health Service</span> US Health Dept. branch regarding the health of Native Americans

The Indian Health Service (IHS) is an operating division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing direct medical and public health services to members of federally recognized Native American Tribes and Alaska Native people. IHS is the principal federal health care provider and health advocate for American Indian people.

The Alaska Native Regional Corporations were established in 1971 when the United States Congress passed the Alaska Native Claims Settlement Act (ANCSA) which settled land and financial claims made by the Alaska Natives and provided for the establishment of 13 regional corporations to administer those claims.

The Harvard Project on American Indian Economic Development, also known as the Harvard Project, was founded in 1987 at Harvard Kennedy School at Harvard University. It administers tribal awards programs as well as provides support for students and conducting research. The Harvard Project aims to understand and foster the conditions under which sustained, self-determined social and economic development is achieved among American Indian nations through applied research and service.

Santa Clara Pueblo v. Martinez, 436 U.S. 49 (1978), was a landmark case in the area of federal Indian law involving issues of great importance to the meaning of tribal sovereignty in the contemporary United States. The Supreme Court sustained a law passed by the governing body of the Santa Clara Pueblo that explicitly discriminated on the basis of sex. In so doing, the Court advanced a theory of tribal sovereignty that weighed the interests of tribes sufficient to justify a law that, had it been passed by a state legislature or Congress, would have almost certainly been struck down as a violation of equal protection.

Cherokee Nation of Oklahoma v. Leavitt, 543 U.S. 631 (2005), was a United States Supreme Court case in which the Court held that a contract with the Federal Government to reimburse the tribe for health care costs was binding, despite the failure of Congress to appropriate funds for those costs.

The practice of dental care in rural Alaska is overseen by the American Dental Association and other organizations under the jurisdiction of dentistry in the United States, with major differences from dentistry in the contiguous states. The oral health situation among the Alaskan Native population is among the most severe globally, with notably high rates of oral disease. Children in this population aged 2 to 5 years have almost five times the amount of tooth decay as children of the same age elsewhere in the United States, and adults have 2.5 times the amount of tooth decay as adults elsewhere. Other factors impacting the population's dental health include the difficulty of obtaining fresh food in remote locations, lack of fluoridated running water, and reduced access to education on the importance of dental health.

<span class="mw-page-title-main">Yvette Roubideaux</span> American physician

Yvette Roubideaux is an American doctor and public health administrator. She is a member of the Rosebud Sioux Tribe of South Dakota.

The Northwest Portland Area Indian Health Board (NPAIHB) is a non-profit tribal advisory organization in Portland, Oregon, run and organized by participating tribes. It was established in 1972 to focus on four areas as they pertain to the health of Native people: health promotion and disease prevention, legislative and policy analysis, training and technical assistance, and surveillance and research. It serves 43 federally recognized tribes in Oregon, Washington and Idaho, with each tribe appointing a delegate to the board that oversees the NPAIHB. The board meets quarterly to discuss current projects and issues.

Southeast Alaska Regional Health Consortium (SEARHC) is a non-profit medical, dental, vision and mental health organization serving the health interests of the residents of Southeast Alaska.

Salazar v. Ramah Navajo Chapter, 567 U.S. 182 (2012), was a United States Supreme Court case in which the Court held that the United States government, when it enters into a contract with a Native American Indian tribe for services, must pay contracts in full, even if Congress has not appropriated enough money to pay all tribal contractors. The case was litigated over a period of 22 years, beginning in 1990, until it was decided in 2012.

Independent tribal courts are judicial systems that are established and operated by Native American tribes within the United States. These courts are separate from the federal and state court systems and are designed to handle legal matters within the tribe's jurisdiction. The purpose of independent tribal courts is to provide a legal framework for Native American tribes to govern themselves and to resolve disputes within their communities, without interference from the United States federal or state governments. The independent tribal court system is an important tool for tribes to maintain their own legal traditions and to resolve disputes within their communities.

<span class="mw-page-title-main">Native Americans and reservation inequality</span> Social issue in the U.S.

Native American reservation inequality underlies a range of societal issues that affect the lives of Native American populations residing on reservations in the United States. About one third of the Native American population, about 700,000 people, lives on an Indian Reservation in the United States. Reservation poverty and other discriminatory factors have led to persisting social inequality on Native American reservations. Disparities between many aspects of life at the national level and at the reservation level, such as quality of education, quality of healthcare, substance use disorders, teenage pregnancy, violence, and suicide rates are significant in demonstrating the inequality of opportunities and situations between reservations and the rest of the country.

Contemporary Native American issues in the United States are topics arising in the late 20th century and early 21st century which affect Native Americans in the United States. Many issues stem from the subjugation of Native Americans in society, including societal discrimination, racism, cultural appropriation through sports mascots, and depictions in art. Native Americans have also been subject to substantial historical and intergenerational trauma that have resulted in significant public health issues like alcohol use disorder and risk of suicide.

<span class="mw-page-title-main">Native American policy of the Barack Obama administration</span>

The United States public policy agenda on issues affecting Native Americans under the Obama administration includes the signing of the Tribal Law and Order Act of 2010, which allowed tribal courts to extend and expand sentences handed down to them in criminal cases, strengthening tribal autonomy. Obama also supported and enforced the Executive Order 13175, which requires the federal government to consult with tribal governments when deliberating over policies and programs that would affect tribal communities. Under the Obama Administration was also the launching of Michelle Obama's program Let's Move In Indian Country, which aims to improve opportunities for physical activity, to increase access to healthy food in tribal communities, and to create collaborations between private and public sectors to build programs that will end childhood obesity in Native communities. Obama also supported tribal communities through certain provisions of the American Recovery and Reinvestment Act of 2009, which allocated $510 million for rehabilitation of Native American housing, and the settlement of the Keepseagle case, a lawsuit against the United States Department of Agriculture for discriminating against tribal communities by not allowing them equal access to the USDA Farm Loan Program. Most recently, Obama signed Executive Order 13592, which seeks to improve educational opportunities for American Indian and Alaska Natives. Obama has been praised by many tribal leaders, including those who claim he has done more for Native Americans than all of his predecessors combined.

Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, 577 U.S. ___ (2016), was a case in which the Supreme Court of the United States clarified subrogation procedures under the Employee Retirement Income Security Act ("ERISA"). The Court held that healthcare plan fiduciaries cannot demand reimbursement for medical benefits from a plan member's general assets if the beneficiary's general assets cannot be traced back to the original payment from the fiduciary. Although some scholars suggested that the court's ruling would have little impact, others suggested the case places "significant restrictions" on the rights of ERISA benefit plan providers.

<span class="mw-page-title-main">Medical deserts in the United States</span> Areas with limited access to healthcare in the United States

The United States has many regions which have been described as medical deserts, with those locations featuring inadequate access to one or more kinds of medical services. An estimated thirty million Americans, many in rural regions of the country, live at least a sixty-minute drive from a hospital with trauma care services. Regions with higher rates of Medicaid and Medicare patients, as well those who lack any health insurance coverage, are less likely to live within an hour of a hospital emergency room. Although concentrated in rural regions, health care deserts also exist in urban and suburban areas, particularly in predominantly Black communities in Chicago, Los Angeles and New York City. Racial demographic disparities in healthcare access are also present in rural areas, particularly in Native American communities which experience worse health outcomes and barriers to accessing quality medical care. Limited access to emergency room services, as well as medical specialists, leads to increases in mortality rates and long-term health problems, such as heart disease and diabetes.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on Native American tribes and tribal communities</span> Effects of the viral outbreak on tribal communities

The impact of the COVID-19 pandemic on Native American tribes and tribal communities has been severe and has emphasized underlying inequalities in Native American communities compared to the majority of the American population. The pandemic exacerbated existing healthcare and other economic and social disparities between Native Americans and other racial and ethnic groups in the United States. Along with black Americans, Latinos, and Pacific Islanders, the death rate in Native Americans due to COVID-19 was twice that of white and Asian Americans, with Native Americans having the highest mortality rate of all racial and ethnic groups nationwide. As of January 5, 2021, the mortality impact in Native American populations from COVID-19 was 1 in 595 or 168.4 deaths in 100,000, compared to 1 in 1,030 for white Americans and 1 in 1,670 for Asian Americans. Prior to the pandemic, Native Americans were already at a higher risk for infectious disease and mortality than any other group in the United States.

Yellen v. Confederated Tribes of the Chehalis Reservation, 594 U.S. ___ (2021), was a United States Supreme Court case dealing with the classification of Alaska Native corporations (ANCs) for purposes of receiving funds set-aside for tribal governments under the CARES Act. In a 6–3 decision issued in June 2021, the Court ruled that ANCs were considered to be "Indian tribes" and were eligible to receive the set-aside funds.

American Hospital Association v. Becerra, 596 U.S. 724 (2022), was a United States Supreme Court case relating to administrative law. The case centered on a rule from the Department of Health and Human Services, which reduced reimbursement rates for certain hospitals. Several hospital associations and hospitals affected by the rule sued HHS, alleging that it exceeded its statutory authority. The court was tasked with deciding if the rule was a reasonable interpretation of the law, and if the statute blocked judicial review of the rule in the first place.

References

  1. Blodger, Ian; Huebner, Brock; Leano, Jessica; Wells, Steven (June 6, 2024). "The Supreme Court Update - June 6, 2024". Dorsey & Whitney .
  2. Owens, Crystal (November 20, 2023). "Justices Will Hear Dispute Over Native Health Care Payments". Law360 .
  3. Babbitt, Christopher; Beaudreau, Tommy; Lamb, Kevin; Powell, Laura; Riley-Swanbeck, Britany; Volchok, Daniel; Waxman, Seth (June 12, 2024). "In Narrow Victory for Tribal Nations, US Supreme Court Requires Federal Government to Reimburse Tribal Nations for Healthcare Administration Costs". WilmerHale .
  4. Azkalny, Abdullah; Lokensgard, Steve; Peterson, Josh; Taticchi, Mark (June 6, 2024). "Supreme Court Decides Becerra v. San Carlos Apache Tribe". Faegre Drinker .
  5. Morse, Susan (June 6, 2024). "Supreme Court decision a win for Tribal health finances". Healthcare Finance News.
  6. Howe, Amy (November 20, 2023). "Justices take up Native health care funding cases and a dispute over sentencing guide". SCOTUSblog .
  7. "Becerra v. San Carlos Apache Tribe". The Federalist Society .
  8. "Becerra v. San Carlos Apache Tribe". Oyez .
  9. Strawbridge Robinson, Kimberly (November 20, 2023). "Supreme Court to Resolve Split Over Tribal Health Care Funds". Bloomberg Law .
  10. Pierson, Brendan (June 6, 2024). "US must pay more of Native American tribes' healthcare costs, Supreme Court rules". Reuters .
  11. 1 2 Haberman, Hannah (March 27, 2024). "SCOTUS hears arguments about a case involving federal health funding for the Northern Arapaho Tribe". Wyoming Public Media.
  12. Strawbridge Robinson, Kimberly (March 25, 2024). "Supreme Court Struggles With Tribal Health Care Funding Case (1)". Bloomberg Law .
  13. McKinney, Ian (March 26, 2024). "Tribes, feds spar before Supreme Court over who pays for health care". Indianz.Com.
  14. Dallas, Kelsey (June 6, 2024). "Trump's first Supreme Court appointee has once again broken from the conservative pack". Deseret News .
  15. Carter, Stephen (June 7, 2024). "Supreme Court Gets It Right on Tribal Health Care". Bloomberg .
  16. Chappie, Brianna (June 6, 2024). "Supreme Court rules in favor of two Native American tribes in dispute with federal government over insurance billing fees". Cronkite News .
  17. Howe, Amy (June 6, 2024). "Supreme Court rules U.S. must pay more for Native American tribes' health care". SCOTUSblog .
  18. Heckman, Carol; Myrtle, Kathryn; Rossetti, Michael (June 10, 2024). "Supreme Court Decides in Favor of Tribal Nations in Becerra v. San Carlos Apache Tribe". Lippes Mathias LLP.
  19. Rickert, Levi (June 6, 2023). "Supreme Court Backs Tribes in Healthcare Funding Dispute". Native News Online .
  20. Fung, Katherine (June 6, 2023). "Supreme Court Hits Biden Admin With a Bill". Newsweek .
  21. McNeil Staudenmaier, Heidi; Haake, Kelsey (June 13, 2024). "Supreme Court Ruling Supports Tribal Healthcare Funding and Self-Determination". Reuters .
  22. Deese, Kaelan (June 6, 2024). "Supreme Court sides with tribes in federal healthcare funding dispute". The Washington Examiner .
  23. Strawbridge Robinson, Kimberly (June 6, 2024). "Supreme Court Rules For Tribes Aiming to Recoup Health Costs (1)". Bloomberg Law .
  24. Whitehurst, Lindsay (June 6, 2024). "Supreme Court sides with Native American tribes in health care funding dispute with government". The AP .