A Closer Look at Tribal Health
There are 565 federally recognized American Indian/Alaska Native tribal governments in the United States with distinctive histories, cultures, languages and populations. Some Native American groups currently lack federal recognition, although they may have distinctive legal status under state law and for purposes of some federal programs.
Although tribal governments vary structurally, they all exercise inherent sovereignty over their members and territories. Tribal governments maintain a unique political relationship with the United States, which enables Congress to enact legislation protecting tribal rights and manifesting a “trust relationship” under U.S. federal Indian law. The federal Indian Health Service primarily fulfills this role with respect to health issues affecting American Indians and Alaska Native peoples. The Indian Healthcare Improvement Act, the cornerstone of legal authority governing the health status of tribal populations, was permanently reauthorized in 2010 through the Patient Protection and Affordable Care Act.
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