Brayden Jack Parker
90 Geo. Wash. L. Rev. 237
In 1976, the federal government passed the Indian Health Care Improvement Act (“IHCIA”) in furtherance of its special trust responsibility owed to Native Americans. Through the IHCIA, Congress created the Indian Health Service, which provides health care to five million members of federally recognized tribes. In recent years, however, the Indian Health Service’s quality of care has suffered. And yet, circuit courts are split as to whether tribal members are able to legally enforce the quality of care that the IHCIA promised. The Ninth Circuit held that no fiduciary duty to provide health care exists. The Eighth Circuit found the duty located in ancient treaty language. The Supreme Court has yet to provide clarification.
This Note argues that statutory schemes such as the IHCIA alone create a trust duty to provide quality health care to tribal members, and the duty is enforceable against the federal government. Although courts could use unabrogated treaty language to create the trust duty, this framework is unsustainable because the nature and history of treaty negotiations gift different tribes with more rights than others. Regardless, such an analysis remains unnecessary because proper statutory interpretation confirms that the IHCIA created a fiduciary duty to provide adequate health care.
