Title 25IndiansRelease 119-73

§1647d Navajo Nation medicaid agency feasibility study

Title 25 › Chapter CHAPTER 18— - INDIAN HEALTH CARE › Subchapter SUBCHAPTER III–A— - ACCESS TO HEALTH SERVICES › § 1647d

Last updated Apr 6, 2026|Official source

Summary

The Secretary must study whether the Navajo Nation can be treated like a State for Medicaid (the program under title XIX of the Social Security Act). The study must look at whether payments now made to Arizona, New Mexico, or Utah for services to Navajo residents could instead go to a Navajo-run agency, whether the Federal Government can help the Navajo Nation build and run that agency to handle eligibility, payments, and care, whether appropriate Federal matching funds would be available, and whether the Navajo Nation could choose to be treated like a State for the Children’s Health Insurance Program under similar terms. Not later than 3 years after March 23, 2010, the Secretary must send a report to the Committee on Indian Affairs and the Committee on Finance of the Senate and the Committee on Natural Resources and the Committee on Energy and Commerce of the House of Representatives. The report must include the study results, a summary of consultations with the Navajo Nation, other tribes, the States of Arizona, New Mexico, and Utah, affected counties and others, estimated costs or savings and service impacts, and any legislation needed to set up such an entity.

Full Legal Text

Title 25, §1647d

Indians — Source: USLM XML via OLRC

(a)The Secretary shall conduct a study to determine the feasibility of treating the Navajo Nation as a State for the purposes of title XIX of the Social Security Act [42 U.S.C. 1396 et seq.], to provide services to Indians living within the boundaries of the Navajo Nation through an entity established having the same authority and performing the same functions as single-State medicaid agencies responsible for the administration of the State plan under title XIX of the Social Security Act.
(b)In conducting the study, the Secretary shall consider the feasibility of—
(1)assigning and paying all expenditures for the provision of services and related administration funds, under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.], to Indians living within the boundaries of the Navajo Nation that are currently paid to or would otherwise be paid to the State of Arizona, New Mexico, or Utah;
(2)providing assistance to the Navajo Nation in the development and implementation of such entity for the administration, eligibility, payment, and delivery of medical assistance under title XIX of the Social Security Act;
(3)providing an appropriate level of matching funds for Federal medical assistance with respect to amounts such entity expends for medical assistance for services and related administrative costs; and
(4)authorizing the Secretary, at the option of the Navajo Nation, to treat the Navajo Nation as a State for the purposes of title XIX 11 See References in Text note below. of the Social Security Act (relating to the State children’s health insurance program) under terms equivalent to those described in paragraphs (2) through (4).22 So in original. Probably should be paragraphs “(1) through (3).”.
(c)Not later then 3 years after March 23, 2010, the Secretary shall submit to the Committee on Indian Affairs and Committee on Finance of the Senate and the Committee on Natural Resources and Committee on Energy and Commerce of the House of Representatives a report that includes—
(1)the results of the study under this section;
(2)a summary of any consultation that occurred between the Secretary and the Navajo Nation, other Indian Tribes, the States of Arizona, New Mexico, and Utah, counties which include Navajo Lands, and other interested parties, in conducting this study;
(3)projected costs or savings associated with establishment of such entity, and any estimated impact on services provided as described in this section in relation to probable costs or savings; and
(4)legislative actions that would be required to authorize the establishment of such entity if such entity is determined by the Secretary to be feasible.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Social Security Act, referred to in subsecs. (a) and (b), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. Title XIX of the Social Security Act (relating to the State children’s health insurance program), referred to in subsec. (b)(4), probably means title XXI of the Act, which is classified generally to subchapter XXI (§ 1397aa et seq.) of chapter 7 of Title 42 and relates to the State Children’s Health Insurance Program. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables. Codification section 411 of Pub. L. 94–437 is based on section 159 of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148.

Reference

Citations & Metadata

Citation

25 U.S.C. § 1647d

Title 25Indians

Last Updated

Apr 6, 2026

Release point: 119-73