Holden, Nez-Chee: Embracing tradition — advancing Medicaid reimbursement for traditional healing

Christine Holden

Submitted photo

For American Indian tribal communities, traditional healing has been the cornerstone of health and wellness since time immemorial. Rooted deeply in cultural traditions, these practices encompass a holistic approach to our physical, mental, emotional and spiritual well-being.

As we navigate the complexities of Western health care systems, it is imperative that modern medical insurance recognize and reimburse traditional healing practices. Integrating these time-honored customs into the western healthcare framework not only honors the cultural significance of traditional healing, it also enriches the overall effectiveness of health care by embracing a more comprehensive, culturally competent approach to health and wellness.

Cultural competence and health equity

Traditional healing is not just a method of treatment; it is a way of life that honors and respects our ancestors’ wisdom. For many of our relatives, the journey to health and wellness is incomplete without the guidance of traditional healers who use medicinal plants, sacred objects and spiritual ceremonies to treat individuals in a manner that is both culturally appropriate and deeply personal.

For those who receive insurance benefits through Medicaid, reimbursement for traditional healing allows tribal members to access care that respects their cultural identity and promotes health equity.

From our perspective, traditional healing practices are a fundamental element of tribal health care, helping individuals achieve overall better wellness. While traditional healing is a key part of the tribal healthcare system, its availability is often constrained by limited funding, typically funded by grants. Adding Medicaid reimbursement helps bridge the gap in health disparities faced by tribal communities by ensuring broader, more sustainable access to traditional healing. 

Holistic healing

Western medicine often focuses on treating symptoms rather than addressing the root causes of illness. Traditional healing, on the other hand, embodies a holistic view of wellness, considering the interconnectedness of mind, body, spirit and environment.

Traditional practices such as sweat lodges, herbal remedies and spiritual ceremonies have been used for centuries to treat everything from physical ailments to mental health challenges. By incorporating these practices into Medicaid-covered services alongside Western treatments, the state acknowledges their value and effectiveness, thus fostering a more integrative approach to health care.

This holistic approach is not only valued by members of the 22 federally recognized Indian tribes in the state of Arizona, but is also supported at the federal level through the Indian Health Care Improvement Act, demonstrating significance and effectiveness in health care.

Respecting tribal sovereignty

Reimbursing for traditional healing services is also a matter of respecting tribal sovereignty. Each tribe has the right to determine what healthcare looks like for its members. By supporting Medicaid reimbursement for traditional healing, we honor the autonomy of tribal nations to integrate their cultural practices into modern healthcare systems. This not only strengthens our communities but also sets a precedent for other states to follow.

A path forward

States like Arizona and New Mexico are already leading the way in seeking federal approval for Medicaid coverage of traditional healing services. AHCCCS, Arizona’s Medicaid agency, took a historic step and submitted the first-ever request in 2015, and again in 2020, to the national Centers for Medicare and Medicaid (CMS) offices. AHCCCS and multiple other states are currently working with CMS for federal approval of Medicaid coverage for traditional healing.

These efforts represent a significant step forward in recognizing the importance of culturally competent care. As we continue to pursue these changes, it is crucial to highlight the deep significance traditional healing has on our communities’ health and well-being.

The integration of traditional healing practices into Medicaid is not just a policy change; it is a recognition of the value of tribal cultures and traditions. Incorporating traditional Native health into state systems and non-tribal health care systems demonstrates that Arizona recognizes the importance of Indigenous traditions.

It is a powerful step toward a more inclusive and equitable healthcare system that honors the wisdom of our ancestors and meets the needs of our people. Let us continue to advance toward this important change, ensuring that future generations can benefit from the rich traditions that have sustained us for centuries.

Editor’s note: Christine Holden, a member of the White Mountain Apache Tribe and half Hopi, is tribal liaison for AHCCCS. Terrilynn Nez-Chee, a member of the Navajo Nation Tribe, is director of revenue cycle management for the Tse’hootsooi’ Medical Center in Fort Defiance and serves as AHCCCS Traditional Healing Workgroup chair. Reader reactions, pro or con, are welcomed at AzOpinions@iniusa.org.