Medicaid Expansion Questions

Does Governor Martinez have the authority to make the decision for Tribes regarding the Medicaid Expansion?

If the State of NM does not take the Medicaid Expansion can State law overide Federal Law, which Govern the Tribes?

Can Governor Martinez Make the Decision regarding the Medicaid Expansion without Tribal Consultation, according to State Law?


I submitted the following Statement, part of a document, to CMS representative.


"The US Supreme Court’s decision to up hold the PPACA except for the Medicaid Expansion is a concern for Tribes in NM.  If Governor Martinez decides not expand Medicaid for NM’s low income individuals it will have a great effect on the Tribal Health Programs.  NM Native Americans make up between 22%-26% of the Medicaid population with many more individuals eligible but not yet enrolled.  That number will grow with expansion and help many individuals obtain needed healthcare.  This is another instance where the State of NM will make a decision without Consultation with Tribes.  Given the Government to Government relationship what will happen if Tribes want to Expand Medicaid and the State of NM chooses not to?"

This is a question that is the basis of an upcoming purposed Tribal Summit cosponsered by the Center for Law and Poverty, AIPC, NMICoA Health Committee  Tenatively Scheduled for

October 16, 2012  9 AM to 12 PM

Place: TBA

Agenda to follow

There are a couple of opportunities for Tribes to ask this question coming up.  the following statement will be asked at the HHS Secretary Tribal Advisory Committee (STAC)

"Regarding the Governor's authority to expand. An open question that tribes all over the country need clear guidance from CMS on is whether or not a Governor who decides to not expand Medicaid in their state can do so on behalf of Native Americans. Since the Affordable Care Act mandating expansion is a federal law, can a Governor decide to deprive Native Americans of this benefit in the face of the government to government relationship and supremacy? Tribal advocates will need a clear answer on this."

There is also a NCAI the last week of  October, where this question can be posed to all Tribes.