title: American Indian health policy: historical trends and contemporary issues.
abstract: The United States has a trust responsibility to provide services to American Indians and Alaska Native (AI/AN) persons. However, a long-standing history of underfunding of the Indian Health Service (IHS) has led to significant challenges in providing services. Twentieth century laws, including the Snyder Act, Transfer Act, Indian Self-Determination and Education Assistance Act, and Indian Health Care Improvement Act (IHCIA) have had an effect on the way health services are provided. IHCIA was reauthorized as part of the Patient Protection and Affordable Care Act (ACA). Several provisions in ACA allow for potential improvements in access to services for AI/AN populations and are described herein. Although policy developments have been promising, IHS underfunding must be resolved to ensure improved AI/AN health.
authors.affiliation: Donald Warne and Linda Bane Frizzell are with the MPH Program at North Dakota State University, Fargo.
authors.forename: Donald
authors.initials: D
authors.lastname: Warne
authors.forename: Linda Bane
authors.initials: LB
authors.lastname: Frizzell
mesh_terms: D006291:Health Policy / Q000266:history* / Q000331:legislation & jurisprudence / Q000639:trends; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007198:Indians, North American; D014481:United States; D016549:United States Indian Health Service / Q000266:history* / Q000331:legislation & jurisprudence / Q000639:trends
references.citation: J Law Med Ethics. 2011 Mar;39 Suppl 1:42-5
references.pmid: 21309895
references.citation: MMWR Suppl. 2011 Jan 14;60(1):13-7
references.pmid: 21430614