TUCSON, AZ— Recently, Rep. Raúl M. Grijalva sent a letter to Centers for Medicaid and Medicare Services Administrator Seema Verma expressing concern with the Arizona Health Care Cost Containment System 1115 Waiver Amendment Request. The waiver request will allow Arizona to implement work requirements and a five-year maximum lifetime benefit limit for certain Medicaid beneficiaries. Tribal governments were not consulted on the waiver request, and recently courts struck down work requirements in Kentucky. The letter read, in part:

“The United States and tribal governments interact on a government-to-government basis and U.S. Department of Health and Human Services (HHS) tribal consultation policy states, ‘that true and effective consultation shall result in information exchange, mutual understanding, and informed decision-making on behalf of the Tribal governments involved and the Federal Government.’ Further, the HHS tribal consultation policy is intended to ensure access to critical health and human services through meaningful government to government consultation. Any policy implications without adherence to the HHS tribal consultation policy, will drastically affect tribes and infringes upon the federal trust responsibility between tribal and federal governments.

“This waiver could have an impact on the more than 150,000 American Indians and Alaska Natives enrolled in the Arizona Medicaid program, it is unacceptable for the CMS to permit any waiver moving forward that will negatively impact this population. In addition to threatening tribal sovereignty, the changes could result in reduced funds available to the Indian Health Service (IHS). It is essential the U.S. government uphold its federal trust responsibility to tribal communities; for that reason, I urge HHS adhere to its tribal consultation policy by immediately conducting a consultation process regarding the implications of ‘AHCCCS works’ to ensure tribal communities engage in meaningful consultation with the federal government.”

Click here to read the letter in its entirety

Click here to read official comments submitted previously by Rep. Grijalva. 

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