By Elizabeth L. Harrison, Communications Manager
YWCA Missoula

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
– Dr. Martin Luther King

We have all seen firsthand how America’s flawed health care system hurts our clients, our colleagues, our friends and our families. Because the YWCA is committed to racial justice, we also recognize that some Americans face more challenges than others when accessing and receiving health care services. In Montana, American Indians face significant barriers to accessing quality health care, including mistreatment by providers, long drives in bad weather to reach facilities, chronic underfunding of clinics and staff, and cultural differences in communication. These factors have created a health care crisis that demands action.

Of the 33 states with significant Native populations, Montana ranks the highest of any state in uninsured American Indians and the second lowest in the number of American Indians with private insurance. Montana, however, has the highest number of American Indians who report having access to underfunded Indian Health Service (IHS) clinics. IHS clinics serve eligible American Indians regardless of insurance status, but federal funding for these clinics only covers 60% of the need. This underfunding contributes to health disparities for a population that is already disproportionately affected by chronic conditions such as diabetes and heart disease.

YWCA Missoula’s mission is to eliminate racism and empower women. On a daily basis, we bear witness to the affects a lack of insurance and underfunding of Indian Health Service facilities has on Native women and their families – many of whom are entering our programs as a result of a lifetime of domestic violence and/or partner abuse.

Nancy*, a 26-year-old Native woman, recently came to the YWCA with her five-year-old son, Jason. After making the brave decision to leave her abusive partner, she found herself homeless and sought out the YWCA’s transitional housing program. Through the program she was able to afford an apartment for her and her son, which in turn helped her to secure full-time work making minimum wage at a local retail store. However, getting this job presented a double-edged sword for Nancy – once she began working, she lost her Medicaid because wages from her new job pushed her over the income limit. Nancy doesn’t make enough money to pay for the health care her employer provides. Should she choose to try to access a nearby IHS clinic, she would likely experience a lack of access to quality care, including preventative care for her and her son.

This legislative session, Montana had a unique opportunity to improve healthcare for American Indians like Nancy by expanding Medicaid. If Montana policymakers had chosen to take advantage of this opportunity, almost 20,000 American Indians who are newly eligible for Medicaid, including those who rely on IHS facilities, would have seen improvements in their healthcare. These 20,000 American Indians are part of a larger pool of 60,000 newly eligible Montanans.

If Montana had chosen to expand Medicaid, Nancy would have qualified for benefits and would not have had to cut her hours or turn down promotions just to keep herself and her son healthy. Without an expansion to Medicaid, many Native women like Nancy, who are already facing additional barriers in finding housing, employment and childcare due to discrimination, will have to make tough choices between working and earning more or keeping their health benefits.

Hard-working American Indian families need the security of quality health coverage to get the care they need when they need it without facing overwhelming medical bills. Thanks to Medicaid and the Children’s Health Insurance Program, Montana has successfully brought the uninsured rate for children down to record lows. It is time to help their uninsured parents get coverage too so that the whole family can get the care they need to stay healthy – like getting mom’s blood pressure checked and getting her son the asthma medication he needs.

Opting out of the Medicaid expansion doesn’t make moral sense. It leaves thousands of Montana’s American Indian families like Nancy and her son exposed, unable to afford health insurance but not able to participate in Medicaid. For more information about Medicaid expansion, visit the Families USA Medicaid Expansion Center.

*Name changed to protect confidentiality.

YWCA Missoula is dedicated to eliminating racism, empowering women and promoting peace, justice, freedom and dignity for all. Over the past 100 years, we have always responded to the emerging issues facing women in our community. Our programs include services for survivors of domestic and sexual violence, affordable housing for homeless families and a girls’ leadership and empowerment program. Our award-winning racial justice social marketing campaign has been used as a model for other YWCAs in mostly white communities like ours. The women of color we serve in our programs have a harder time finding permanent housing and employment, getting an education, and accessing health care than white women. The messages of our Racial Justice Initiative are intended to be positive, powerful, and accessible, and to be far-reaching in impact. View YWCA Missoula’s latest public service announcements.

Elizabeth grew up in the South, where racism still reverberates throughout its communities. Her parents’ passion for social justice influenced her drive to create a world where everyone is valued and treated with respect. She graduated from the University of Montana with a master’s in journalism and has worked for YWCA Missoula for three years.

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This post is part of the YWCA USA Stand Against Racism blog carnival on issues of race, justice and diversity. We invite you to join the dialogue! Post your comment below, share your story and follow the conversation on Twitter with the hashtag #StandAgainstRacism.