Back to Insurance Topics
Last Updated: 09/26/2024
In the United States, American Indian and Alaska Native (AI/AN) tribes are considered sovereign nations which means they have authority to govern and regulate themselves. While insurance is regulated by the states, AI/AN nations are free to regulate the business of insurance within their own territories.
AI/AN nations deal with many of the same insurance issues as the rest of the country including, access to affordable healthcare, natural disaster and climate risk, and availability of insurance products.
In 2020, the Navajo Nation was hit hard by Covid-19 and the Indian Health Service (IHS) was facing major medical staff shortages, making receiving and providing healthcare difficult. This was exacerbated by the fact that up to 19.9% of non-elderly American Indian and Indigenous people are uninsured, which is nearly three times more than White Americans. Although this number has dropped 12% (32.4%) in the past 10 years, around 18.8% of AI/AN people are still without health insurance.
In 1921, U.S. Congress passed the Snyder Act, which allowed congress to provide funds for AI/AN health insurance through the Bureau of Indian Affairs (BIA). This authority was moved from the BIA to the Public Health Service when the Transfer Act was passed in 1954. Public Health Services was made responsible for the “maintenance and operation of hospital and health facilities for Indians.” It wasn’t until 1970 that the Indian Healthcare Improvement Act (IHCIA) (made permanent in 2010) was passed that allowed AI/AN health programs to utilize Medicaid and Medicare.
The Federal Emergency Management Agency (FEMA) works with a tribal affairs branch to help federally recognized tribes prepare for and respond to climate and property hazards. FEMA provides an Individual Assistance Program, Post-Disaster Hazard Mitigation Grant, U.S. Small Business Administration Disaster Assistance Program, Public Assistance Program, and the National Flood Insurance Program (NFIP). Despite the assistance provided by FEMA, very few tribes actually participate in the programs. A 2013 study by the U.S. Government Accountability Office (GAO) found that “only 37 of 566 federally recognized tribes (7%) were participating in the NFIP and 3 tribes accounted for more than 70% of policies.” Tribal representatives recommended that FEMA might stimulate participation by prioritizing Indian lands mapping and marketing the program towards tribal leaders opposed to individual representatives
The insurance industry has made diversity and inclusion a priority in recent years and the NAIC aims to provide an ongoing dialogue on the availability of insurance and other topics for American Indian and Alaska Natives (AI/AN).
In 2013, the NAIC formed the NAIC/American Indian and Alaskan Native Liaison Committee to provide a forum for dialogue between NAIC Members and the American Indian and Alaska Native communities on insurance issues of common interest, including availability of insurance and consumer protection issues. The Committee also shares best practices for dealing with insurance issues unique to sovereign tribal nations.
In 2024, the AI/AN is focused on establishing ongoing dialogues into new avenues and innovative solutions for providing access to affordable health care for Native Americans. At the Summer National Meeting, Spencer Davis Leavitt Partners gave a presentation on the American Indian Medical Education Strategies (AIMES) Alliance, with the goal of addressing physician shortages in tribal communities.
View upcoming meetings or use the completed tab to view the last 150 days.
Media queries should be directed to the NAIC Communications Division at 816-783-8909 or news@naic.org.