Document Type



This Roundtable on Health Care Reform was the second Indian Health Service (IHS)-sponsored Roundtable on the topic of Health Care Reform and its impact on Indian health. This second Roundtable was held to provide tribal leaders, urban health care providers, and national Indian organizations with the opportunity to contribute their perspectives on detailed substance of the Health Security Act and other reform proposals, and to provide the IHS with Consensus Statements from which further policy analysis can occur. The Consensus Statements reflected in this document were developed through a process which allowed for presentation of most current information, deliberation, and discussion by Roundtable participants, and formulation of Consensus Statements which best projected the breadth of positions. The Consensus Statements developed by the Roundtable participants focused on the following major issue areas: 1) tribal sovereignty; 2) comprehensive and supplemental benefits; 3) governance and structure; 4) eligibility and enrollment; 5) financing; and 6) transition and competition. A major overriding concern expressed by Roundtable participants that influenced the discussion of every major aspect of Health Care Reform were the cutbacks to the IHS in fiscal years 1994 and 1995. These cuts will cause devastating and potentially irreparable harm to the Indian health care delivery structure nationally. The Roundtable participants stated repeatedly, that it will be impossible for the Indian health care system to withstand the magnitude of proposed staffing and budget cuts, and still compete under the new Health Care reform system.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (RT-14).