The state of Washington is helping Native Americans access health care after decades of barriers.

Health insurers have made it difficult for tribal members to get care covered, despite state and federal laws that bar this.

Vicki Lowe is the executive director of the American Indian Health Commission, which has led efforts to remove hurdles for Native Americans.

She said health insurers would try to make tribal clinics charge out-of-network rates, and wouldn't honor their referrals.

However, the Washington State Office of the Insurance Commissioner has come out with guidance to prevent this.

"Not only will tribes have more money to help pay for services for their tribal members, tribal members will get care in a more timely manner," said Lowe. "So those two things just are really important, and insurance companies have been a barrier for that for decades."

Washington is among the first states to move forward with guidance for insurers and also enforcement of the law so that insurers will stop putting up roadblocks for tribal members to get care in the state.

Todd Dixon is the deputy commissioner for consumer protection and the tribal liaison for the Office of the Insurance Commissioner.

He said one reason for releasing the guidance was that the agency has seen an uptick in complaints - the number one compliant typically coming from billing managers at clinics.

"It says, 'Hey, we have an enrolled member. He or she was seen at our clinic. We billed the insurance company. They said we're out of network and so "we're only paying 60%." And then they send a bill to the enrolled member,'" said Dixon. "It's not how it works."

The Insurance Commissioner's office has been sending notices to insurers who violate protections for Native Americans.

Lowe said before they got involved, tribes fighting with insurers on their own were getting them nowhere. But it's different with the state backing them.

"Knowing that if somebody violates these laws that they're going to get that outreach from the insurance commissioner and that they have 15 days to respond," said Dixon. "Where if a tribe asked them, they would maybe not respond or respond in some convoluted way - it's a power shift to really have the state agency behind this."

Indigenous people have made great contributions to the state of Wisconsin yet the alarming rates of violence against them remains a public health crisis.

A new study showed intimate partner violence disproportionately impacts Indigenous women more than any other ethnic or racial group in the U.S. The murder rate for Native American women and girls is up to 10 times higher than the national average, according to the U.S. Department of Justice, yet they account for less than 1% of the population.

Desiree Tody, outreach program coordinator at the Center Against Sexual and Domestic Abuse and a member of the Red Cliff Band of Lake Superior Chippewa, said violence against Native women is underreported and unaddressed.

"There's jurisdictional issues that come into play as to how things are investigated, how things are tried, and there's always racism," Tody observed. "There's less attention paid to the individuals that some of these things happen to."

The Wisconsin Department of Justice created a task force to combat violence against Native women across the state after legislation which would have addressed the issues failed to pass. There are currently no upcoming task force meetings listed on the newly updated DOJ website.

Poor tracking and data collection are among the many issues contributing to the epidemic among Indigenous women. During a multistate march last month, Tody read a list of names of Indigenous people from Minnesota who had died from domestic violence. No such list currently exists for Wisconsin and Tody noted she is working to change it.

She emphasized the great need to address the systems in place, which continue to fail Native people.

"I have three daughters that I want them to grow up as strong Native women and I want them to grow up safely as strong Native women," Tody explained. "This is their futures on the line. This is their ability to walk down a street safely."

Research shows Indigenous women also face significant barriers when seeking help after experiencing domestic violence. A survivor of domestic violence herself, Tody works with the Center Against Sexual and Domestic Abuse to provide resources for those affected in Bayfield and Ashland counties. Gov. Tony Evers has proposed a $20 million funding increase for domestic abuse services in his current executive budget.


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More than 14,000 incarcerated people in Washington are not able to vote and two bills in Olympia aim to change it.

One bill would make voting more accessible for people in jail by improving access to the voter's pamphlet and voter registration forms. Another would allow people in prison in Washington to vote for the first time in the state's history.

Charles Longshore is incarcerated at the Washington Corrections Center for Men in Shelton. He does advocacy work from prison and said without the right to vote, it is not easy to get a legislator's attention.

"I've helped draft a bill that's before the legislature this session and leading on several other bills," Longshore pointed out. "But I find that it's difficult because you have no reason to be accountable to me."

Longshore is a Skokomish tribal member and said giving the vote to incarcerated people would help right historical wrongs against Indigenous people, who were not given the full right to vote until 1965. Data show Native Americans are vastly overrepresented in the criminal legal system.

Opponents of allowing people to vote from prison said voting is a privilege and breaking laws should mean you lose your voice.

Anthony Blankenship, senior community organizer for the advocacy group Civil Survival, said everyone is a constituent, whether they get to choose who represents them or not. He argued allowing incarcerated people to vote will help with their rehabilitation.

"We have to be able to see and understand what they need to be successful and what they need to not recidivate or go back to prison or harm anyone ever again," Blankenship emphasized.

Blankenship added it is unlikely the bills will pass this session but it is important to keep raising the issue.

"We have to keep on pushing," Blankenship urged. "We have to keep on saying that these are opportunities for people to be part of our community and not be on the outside looking in."

Three Montana bills regarding Native rights and culture advanced from the Senate to the House this week, despite some previous setbacks. Bills to revise the Montana Indian Child Welfare Act and Indian Education for All laws, both tabled within the last month, were this week both passed the Senate and were transmitted to the House. The education bill would require more tribal consultation, more work with language and culture specialists, and more accountability from the state's Board of Public Education.

Keaton Sunchild, director of government and political relations for Western Native Voice, says understanding historical context is critical.

"I think it's hugely important that we continue to teach the history and the culture of Native Americans here in Montana," Sunchild said. "It's pretty hard to do any sort of Montana history without talking about Native American history."

Senate Bill 147 would expand the 2023 Indian Child Welfare Act to include more frequent and robust tribal participation, in recognition of the cultural losses an Indian child placed in a nonnative foster home may experience. In 2020, American Indian children made up 9% of all Montana children, but were 35% of kids in foster care, according to the state's judicial branch.

A bill to make voting more accessible for Native communities was heard last week, but still requires a vote. Sunchild said the major arguments he's heard against the bill are around the costs of implementing more resources for voters, but added that those one-time government costs would save many individuals' repeated costs.

"Between gas, food, child care, days off work, we have voters who are paying $200 sometimes, if not more, to go vote. Voting's inherently supposed to be free," Sunchild continued. "And we're saying that it's really not for Native American communities."

A bill to recognize Indigenous People's Day as a legal holiday in Montana passed the Senate on Wednesday almost unanimously. Sunchild said this version received more support than its predecessors because it calls for the holiday in conjunction with, instead of replacing, Columbus Day.