Regional, National Associations May Be the Future for Native Health Insurance

Robert Weaver is thinking big when it comes to the future of American Indian health insurance.

How big? Regional and national associations of tribes and Native businesses banding together to save 15-20 percent of health costs.

The vehicle he sees is a federal program called Association Health Plans (AHP). It is quite an old program, but the Department of Labor has just issued new regulations that make it easier for associations of like communities to band together for better pricing.

Tribes are already communities that have banded together, and Native businesses can easily create associations as well.

“This is very new. This is the future,” says Weaver, a Quapaw tribal member who started RWI Benefits in 2007 to bring better access and pricing of health benefits to Indian Country. (RWI, based in Miami, Okla., a broker and consultant, was named Native American Business of the Year for 2017 by the National Center for American Indian Enterprise Development.)

The associations will follow what Weaver calls “the golden rule of insurance”—the economies of scale that can be achieved by larger groups of insureds. “The more people on a plan, the more doctors and pharmacies will negotiate with you,” he says.

“All Indian Country should be looking at it now,” he maintains. “Everyone can do an AHP as of April 2019. That’s right around the corner. We could get Indian Country to unite, regionally and nationally. It won’t replace IHS but it will make plans much cheaper. It’s a win-win for IHS, the U.S. government, states, and tribes.”

The wider reach of the associations would have a great effect on the number one barrier to health benefits for Natives. “Access,” Weaver says. “Access is the big need.”

He points to his own tribe as an example. “Most Americans believe Indians get all of our health care paid for,” he asserts. But of 5,000 Quapaw tribal members nationwide, “only about 600 Quapaw can access an Indian Health Service center because of geographical reasons.”

Weaver got his start in Native health benefits when his tribe called him in to do an assessment of costs in setting up a tribal health plan in connection with the building of a tribal casino.

“I couldn’t believe the pricing,” he remembers. He recalls thinking, “I can do this cheaper than what they’re doing. If I can save $4.6 million for my tribe, just imagine what we could do with that money.”

The Quapaw universal health plan includes medical, dental, vision and end of life coverage (basically life insurance). “That has been a tremendous help to the Quapaw people,” he says.

Since starting RWI Benefits, the company has expanded to offer services to tribes across five states, representing more than 16,000 members.

“It’s a learning process,” he says of the insurance business. “I started as a 29-year-old. I’d worked in a hospital, worked in a mental health center. Several family members died from suicide, overdoses, opioids. So I wanted to make sure we have access to quality care. Why are my people not getting fair treatment?”

The firm also provides contract analysis, exposure identification, public speaking, sovereignty protection, and tribal consultancy.

“We’ve seen amazing progress in the last decade. The next decade will be even greater,” he believes.

“Everybody hates to talk about insurance,” he acknowledges. “But people that have it tend to live longer.”