Supreme Court sides with Native American tribes in health care funding dispute with government

WASHINGTON — The Supreme Court sided with Native American tribes Thursday in a dispute with the federal government over the cost of health care when tribes run programs in their own communities.

The 5-4 decision means the government will cover millions in overhead costs that two tribes faced when they took over running their health care programs under a law meant to give Native Americans more local control.

Covering those costs is “necessary to prevent a funding gap,” Chief Justice John Roberts wrote in the majority opinion, joined by the three liberal justices and fellow conservative Justice Neil Gorsuch. Not reimbursing them forces tribes to “pay a penalty for pursuing self-determination.”

The Department of Health and Human Services had argued it isn’t responsible for the overhead costs associated with billing insurance companies, Medicare and Medicaid.

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Paying those costs for all tribes that run their own health care programs could total between $800 million and $2 billion per year, the agency said.

“The extra federal money that the Court today green-lights does not come free,” Justice Brett Kavanaugh wrote in the dissent, which was joined by other conservative Justices Clarence Thomas, Samuel

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