- Associated Press - Monday, March 30, 2020

FLAGSTAFF, Ariz. (AP) - Plans for a Navajo Nation entity to manage Medicaid on the New Mexico portion of the reservation have stalled over disagreements between the tribal president and lawmakers.

The Naat’aanii Development Corp. has been touting a plan that would incorporate traditional healing, customer service in the Navajo language and food boxes for a population that is disproportionately affected by diabetes.

The corporation hit another snag last week when tribal President Jonathan Nez vetoed a resolution that he said “unconscionably” tried to capitalize on the spread of the coronavirus. He said the resolution - which was unanimously approved by tribal lawmakers - didn’t constitute an emergency as written.

Nez also has said he doesn’t support a system to automatically enroll more than 80,000 Medicaid-eligible Navajos in the tribal corporation’s plan without their consent.

Navajo Nation Council Delegate Daniel Tso said lawmakers were right to fast-track the resolution and was baffled by Nez’s veto. He said Monday he would lead an effort to override the veto, but that doesn’t guarantee the plan would move forward.

“It will be the official position of the governing body of the Navajo Nation,” he said. “I don’t know how the (New Mexico) governor will view it.”

New Mexico’s role going forward was not immediately clear. Jodi McGinnis-Porter, a spokeswoman for the state Human Services Department, didn’t immediately respond to an email Monday. She had said previously that the state still was waiting formal word from the Navajo Nation.

“The state of New Mexico supports the Navajo Nation in exercising its power of self-governance to determine how best to provide access to quality health care for Navajo citizens,” she said.

The Navajo Nation announced an ambitious mission several years ago to run its own Medicaid program that would cover eligible tribal citizens in New Mexico, Arizona and Utah, the three states that include the Navajo reservation, and provide culturally appropriate health care. The tribe envisioned the federal government largely picking up the price tag, but the broader program never got started.

A study commissioned by the Centers for Medicare and Medicaid Services found it could take about five years for a Navajo Medicaid agency to be designed and implemented if Congress approved it.

“That’s the ultimate goal for us, not just piecemeal sections but really be like a state-like Department of Health,” Nez recently told The Associated Press.

Navajo lawmakers approved a measure earlier this year asking the state of New Mexico to work with the Naat’aanii Development Corp. and Molina Healthcare Inc. on what could be the first Indian Managed Care Entity in the country. At the time, the corporation said it hoped to launch in the fall.

Native Americans are eligible to receive health care at Indian Health Service hospitals and clinics run directly by the federal government or by tribes and tribal entities. But the agency is chronically underfunded, and Medicaid funds help fill the gap.

The Centers for Medicare and Medicaid Services approved a waiver in 2017, allowing New Mexico to collaborate with Indian Managed Care Entities, including on a pilot project with the Navajo Nation or a tribal entity and require that Native American or Alaska Native populations in specific zip codes or zones enroll in a managed care delivery system.

The Naat’aanii Development Corp. was the only tribe or tribal entity that responded to a request from the state in 2018 soliciting proposals for a pilot project.

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