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

abcnews.go.com:

The Supreme Court is siding with Native American tribes who said they faced increased costs after taking over management of their own health care programs from the federal 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.

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 Alito and Amy Coney Barrett. “In my view, the court should leave those difficult appropriations decisions and tradeoffs to Congress.”

The federal Indian Health Service has provided tribal health care since the 1800s under treaty obligations, but the facilities are often inadequate and understaffed, the San Carlos Apache Tribe in Arizona said in