Here is the complaint in Gila River Indian Community v. Dept. of Veterans Affairs (D. Ariz.):
In 2010, the Patient Protection and Affordable Care Act (“ACA”) was enacted. One goal of the ACA was to improve health care access and delivery for Native Americans. A provision in the ACA allows Indian tribes to be reimbursed for health care provided to veterans and states:
The Service, Indian tribe, or tribal organization shall be reimbursed by the Department of Veterans Affairs or the Department of Defense (as the case may be) where services are provided through the Service, an Indian tribe, or a tribal organization to beneficiaries eligible for services from either such Department, notwithstanding any other provision of law.
25 U.S.C. § 1645(c). This law provides that, if an Indian tribe or tribal organization provides health care services to an individual who is otherwise eligible for care from the VA, the VA must reimburse the Indian tribe or tribal organization for the services provided. Despite this plain and mandatory language directing the Department of Veterans Affairs (“VA”) to reimburse Indian tribes and tribal organizations for health care services provided to veterans, the VA refuses to do so unless Indian tribes and tribal organizations agree to conditions well beyond the plain language of the law and which reduce the reimbursements that Indian tribes are entitled to under the law.