health care – Turtle Talk

This Note examines federal-state and federal-tribe relationships through a comparison of Medicaid and the Indian Health Service (IHS). Analysis of tribal contracting and compacting documents and Medicaid state plans reflects the history of each program: Medicaid is a product of trusting federal-state collaboration, while the IHS reflects a history of distrust between tribes and executive-branch agencies in particular. This finding suggests that IHS compacting and contracting practices have significant lessons for Medicaid as the latter program negotiates with a hostile federal government.

Pechanga Sues IHS over Denial of Funds for Opioid Treatment Facility

January 6, 2026Matthew L.M. Fletcher

Here is the complaint in Pechanga Band of Indians v. Kennedy (C.D. Cal.):

1 Complaint Download

Michigan Federal Court Rejects Saginaw Chippewa Claims in Suit against Insurance Company over Medicare-Like Rates

October 1, 2025Matthew L.M. Fletcher

Here are new materials in Saginaw Chippewa Indian Tribe v. Blue Cross Blue Shield of Michigan (E.D. Mich.):

This is a lengthy case, so here is the case tag (link to all the posts).

D.C. Federal Court Rejects Salt River Health Care Funding Claims against Feds

August 18, 2025Matthew L.M. Fletcher

Here are the materials in Salt River Pima-Maricopa Indian Community v. Kennedy (D. D.C.):

42 Amended Complaint

71 Salt River Motion for Summary J

74 Federal Motion for Summary J

78 Salt River Reply

80 Federal Reply

83 DCT Order

Virginia Federal Court Dismisses Nansemond Health Care Funding Suit against Virginia

August 11, 2025Matthew L.M. Fletcher

Here are the materials in Nansemond Indian Nation v. Commonwealth of Virginia (E.D. Va.):

Complaint here.

D.C. Circuit Decides Red Lake Band of Chippewa Indians v. HHS

August 1, 2025Matthew L.M. Fletcher

Here is the opinion in Red Lake Band of Chippewa Indians v. Dept. of Health and Human Services.

Briefs:

Red Lake Brief

US Answer Brief

Lower court materials here.

Fletcher and Wenger on Indian Country Health Care Policy for 2S/IQ/TGD Communities

July 10, 2025Matthew L.M. Fletcher

Matthew Fletcher and Dr. Hannah Wenger have posted “Issues of Contemporary Health Policy and Law for Two-Spirit, Indigiqueer, Transgender and Gender-Diverse Communities in Indian Country” on SSRN.

Here is the abstract:

This policy brief asks a hypothetical question in a political environment in which the U.S. federal government and many states disfavor the delivery of gender-affirming medical care (GAMC) to 2S/IQ/TGD persons, even to the point of criminalizing such care. It further assumes that a tribal nation is willing and capable of delivering GAMC. The answer to the hypothetical question depends on many factors, including (1) whether the state law is authorized by an Act of Congress such as Public Law 280, (2) whether the state law is a criminal law or a civil-regulatory law, and (3) whether the patient or health care professional is a tribal citizen, a nonmember Indian person, or a non-Indian person. The answer here also assumes that the relevant state law does affirmatively criminalize the provision of GAMC and, further, that federal law prohibits the use of federal money by tribal nations to provide GAMC.