Obamacare even reaches the Navajo Nation

The Navajo are moving ahead with plans to become the first Native American tribe to manage its own federally funded Medicaid program -- a move that would essentially treat the Navajo Nation as a separate state when it comes to some health care issues.

The plan's feasibility study is scheduled for review by Congress next month.

The Navajo Nation covers more than 27,000 square miles across Utah, Arizona and New Mexico. More than 100,000 of the tribe's 250,000 members are reportedly eligible for Medicaid, but many have had issues with health care programs available to them across the three states.

Larry Curley, with the Nation's Department of Health, told the Farmington, N.M., Daily Times that Navajo often travel long distances to get to clinics for Medicaid services. In addition, said the paper, "all three states are pursuing their own versions of Medicaid within their state boundaries, which creates issues for Navajo who live in one state but sometimes are closer to services in another."

Permanent re-authorization of the Indian Health Care Improvement Act, passed when President Barack Obama signed the Affordable Care Act into law, allowed the Navajo to fund their feasibility study in 2010.

The Indian Country Today Media Network, quoting a government fact sheet, says Obamacare allows Native American tribes to explore more health care options for their members -- while providing those groups with "state-based health exchanges, no cost-share or co-payments, tax incentives, expansion and most of all reimbursements from third parties."

But it's not going to be easy. Curley estimates the current plan will cost up to $120 million to implement. And officials in the states that overlap with the Navajo Nation are expressing their own doubts.

"If we don't do a lot of planning, there's going to be a lot of collateral damage," David Foster, then chairman of the Health Care Committee for the Association of Commerce and Industry of New Mexico, told the Daily Times last year.

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