HELENA, Mont. – According to the Trump administration, states can impose work requirements on Native Americans who receive Medicaid - a move that could spell doom for some tribal health services.

On Monday, the Centers for Medicare and Medicaid Services Administrator Seema Verma reaffirmed it would work with states to impose requirements on Native Americans.

Eliot Fishman, policy director of the consumer health advocacy group Families USA says tribal health services financially rely on insurance payments from patients to stay open because they get such little funding from Indian Health Service. He says people dropped off Medicaid would also cut into funds for these health providers.

"Essentially, whatever funds they don't have, they do not provide care," he says. "People who need care go without. So there are absolutely lives literally at stake at every tribal health provider in the country that is tied to these potential new limitations on funding."

Montana hasn't announced plans to require work, although state lawmakers attempted to do so when Montana expanded Medicaid in 2015. With Medicaid expansion up for renewal in 2019, some state lawmakers have suggested work requirements should be on the table if the program is to be extended.

Fishman says it's still unclear whether states can legally impose work requirements on anyone. Tribes also have a government-to-government relationship with the United States, further complicating how such a measure would be implemented.

For instance, states are legally forbidden to impose Medicaid cost-sharing measures on Native Americans enrolled in the program. But if states do work on these issues, Fishman says it isn't the work requirements that will keep people off the Medicaid rolls.

"A huge number of additional people, typically a lot more than the people who don't satisfy the new requirement, are the people who aren't able to submit their documentation or their documentation gets bogged down in paper review, he explains.

There are about 70,000 Native Americans in Montana.


get more stories like this via email

By Torsheta Jackson for Yes! Media.
Broadcast version by Terri Dee for Illinois News Connection reporting for the YES! Media-Public News Service Collaboration

Residents of Evanston, Illinois, filed into the Evanston Township High School Auditorium for the reparations committee’s regular meeting on Jan. 11, 2024. People braved the cold winter weather to wait patiently through the meeting’s public comments, musical performances, and education sessions for the announcement of the order in which the next set of residents would receive their reparations funds.

“This information will be available starting Tuesday or Wednesday of next week on the web page and also at 311,” announced Robin Rue Simmons, chair of the Evanston Reparations Committee. “So city staff will be available outside to tell you what your selection number is if you can’t see them on the screen.”

An Excel spreadsheet with unique identifiers for the 454 direct descendants eligible for the second round of housing reparations benefits was projected onto a wall, illuminating the dark space. A gleeful countdown and a click of the sort button prompted cheers and applause from the crowd. The document scrolled for several minutes while residents searched for their numbers on the list.

“The number [doesn’t] matter,” Rue Simmons told the audience. “What matters is the ranking. What place you will be.”

Evanston is the first city in the United States to make financial reparations to its Black residents. Through its Restorative Housing Program, the city gives $25,000 to eligible residents for mortgage assistance, renovations, or a down payment on a home. A later city council vote added a direct cash payment.

Rue Simmons, a former Evanston alderwoman, learned of the local harm to the Black community during her tenure as an elected official. She concluded that the only acceptable legislative tool to advance justice for the Black community was reparations, and thereafter proposed a reparations program in 2019.

“There had been a legacy of slavery in our city,” Rue Simmons says. “Jim Crow-era laws, redlining types of local zoning laws, and other types of discriminating practices that were anti-Black were keeping us racially separated and segregated.”

Before Rue Simmons presented her motion, the Equity and Empowerment Commission, whose members are approved by the city council, held public meetings starting in January 2018, where commission members explored what reparations were needed and wanted, who could be eligible, and how those reparations would be funded. Those conversations led to the Commission’s first set of recommendations to the Evanston City Council to distribute reparations to Black residents. The council approved the final bill in March 2021.

“At that time, we approved it with three priorities that were based on community engagement, and the first was housing. That’s the area of redress that gets the most attention in Evanston,” Rue Simmons says. “But it also included economic development and educational initiatives.” The bill also “established our reparations committee and seeded the fund with the first $10 million of our recreational cannabis sales tax,” explains Rue Simmons.

Although the economic development and educational initiatives are still being programmed, Evanston has made strides in offering reparations for housing. Rue Simmons says the city has dispersed around $3 million in direct benefits to those prioritized as suffering direct harm—Black people who were adults aged 18 and over between 1919 and 1969.

“There were 140 that fall in that category,” says Rue Simmons, who is now the founder and executive director of FirstRepair, a nonprofit focused on advancing local reparations in cities across the country. “They were all about 70 years and older. We even had one recipient that celebrated his 100th birthday.”

Reparations have been part of an ongoing national conversation. The Fair Fight Initiative explains that reparative justice means repairing the harm done to victims “from the terrors of slavery and colonization to the modern struggles against mass incarceration and institutionalized racism.” A federal bill, H.R. 40, named after the 40 acres promised but never given to emancipated slaves, would create a national reparations commission. While the bill has stalled in Congress for more than 30 years, the Biden administration has offered support for federal efforts to confront inequity and structural racism.

There was increased interest in reparations for African Americans during the summer of 2020 in the midst of a historic racial justice uprising in the wake of George Floyd’s murder. Further, the racialized impacts of the COVID-19 pandemic and mass unemployment left many African Americans searching for some form of redress. 

However, as the federal government struggles to determine its role, local communities are taking action. Around a dozen cities across the country are now considering reparations to repair the damage of institutional racism. Reparations advisory committees have explored cash payments, housing grants, and academic scholarships as means of harm repair.

When the Drug War Ends

The state of Illinois passed the Cannabis Regulation and Tax Act in 2019. It was called one of the most equity-centric policies in the nation. It is also one of the first to incorporate reparations for the War on Drugs, which disproportionately targeted Black families and subjected them to mass incarceration, unequal education opportunities, unemployment, increased evictions, and housing displacement. The damage was long-term and irreversible. 

In 2018, a group of formerly incarcerated people in Chicago founded Equity and Transformation (EAT) aimed at individuals like themselves, who were imprisoned for drug offenses during the 1990s. 

EAT has joined other local grassroots organizations in a campaign called “The Big Payback,” aimed at ensuring that part of Illinois’ cannabis tax revenues are paid directly to survivors as cash payments. In 2020, EAT established the Chicago Future Fund, an initiative described as “[u]nconditional, recurring cash transfers [that] are supporting 30 post-incarcerated West Garfield Park residents to determine their own futures.” The program is an example of what reparative justice specifically for post-incarcerated individuals could look like.

“What excites me most is this idea of restitution and the possibility that we can have an imprint on what that benchmark actually provides for our people,” EAT Executive Director Richard Wallace told YES! in a 2023 interview. “What I’m most interested in at this time is exploring rehabilitation and restitution and how we as people [who] have been invested in with social capital, etc. can give back to the community in ways that address those pillars.”

Participants of Chicago Future Fund are required to be between the ages of 18 and 35 and earn less than $12,000 per year in order to receive $500 in monthly payments for 18 months. There are no work requirements or restrictions on how the money can be spent. The first round of payments began on November 15, 2021, and ended in April 2023. 

In its CFF Round 1 evaluation report, EAT framed the program by explaining that “System-impacted individuals confront significant, ongoing obstacles in their everyday lives, including exclusions from employment, housing, and education.” Further, “[t]he tangle of obstacles they face can lead to extreme poverty and, too often, to additional periods of incarceration.” EAT sees the Chicago Future Fund as “an intervention into these systemic inequalities and the vicious cycle of poverty and recidivism they produce.”

Recipients of the funds participated in data collection to gauge how the guaranteed payments affected recidivism, physical and psychological well-being, and income volatility. EAT found increased housing stability and reduced police interactions. Recipients reported using the money to cover regular household expenses, groceries, child care, clothing, and school supplies. Many also reported sharing the stipend with partners, parents, or siblings. 

“I think each pilot, each initiative, essentially adds to the narrative change around reparations. These efforts are part of the larger push for some of the federal policy changes, but that work has to be influenced by what’s bubbling up across Black communities,” Wallace said in an interview with the Bridgespan Group. “We can have a base of people that may be divided by state lines but collectively in agreement by the demands and the purpose of reparations.”

A Tangible First Step

In Asheville, North Carolina, Jim Crow ordinances, redlining, and urban renewal initiatives destroyed Black communities. The Housing Act of 1949 displaced millions of predominantly African American individuals and families between the 1950s and 1980s while clearing blighted neighborhoods. The effects are still felt in the area today. In July 2020, the Asheville City Council passed a resolution supporting a reparations commission to investigate how the city’s discriminatory policies harmed its Black residents. A month later, Buncombe County, which encompasses Asheville, passed a similar resolution. The two initiatives have budgeted more than $5 million with the goal of creating generational wealth for Black residents harmed by income, health care, and educational disparities. 

“I feel like this is an opportunity not to solve, because we’ve had the solutions for a while, but to actually get the solutions that we need implemented in order to reverse the disparate outcomes that are intentional,” says Racial Justice Coalition Executive Director Rob Thomas. “We have all the metrics. We have the data. We have the history. We know what was done. We know how it has impacted us and how it’s continuing to impact this. And we continue to say, ‘Oh, this is too big to tackle’ and it’s not.”

The city and county have already begun work on immediate cease-to-harm actions. Both have conducted internal audits in the five focus areas that include housing, economic development, health, education, and criminal justice. They also examined human resources, equity measures, and legal activities. 

“This is about improving what we do and [ensuring] that we’re not harming Black people any longer … with the policies, practices, and procedures we have,” says Brenda Mills, who recently retired from her position as Asheville Equity and Inclusion Director. 

The Asheville City Council and Buncombe County Board of Commissioners appointed the members of the Community Reparations Commission in March 2022. The commission has spent its time investigating property deeds, tax records, and historical documents to determine how the city damaged Black individuals and neighborhoods through racist policies. It is tasked with providing recommendations for reparative actions for the damage caused by public and private racism in criminal justice, education, economic development, health and wellness, and housing. Committees for each of the five focus areas have suggested repairs such as a community hub with economic resources and health and wellness centers. Mills says cash payments are also an option.

“Those recommendations … have to be something that people read, know what it’s called, and [know] what it is intended to do,” Mills says. “[They have to know] what harm [the measure is] trying to correct or make amends for and where’s the data to that … and then what kind of budget are we looking at.”

Moving Forward

Experts agree that local reparations programs need to be detailed and specific in order to minimize legal challenges. Justin Hansford, executive director of the Thurgood Marshall Civil Rights Center, worked with Rue Simmons to craft the Evanston legislation. Hansford says legislation must be narrowly tailored to address specific harms.

“Communities have to have a very detailed analysis of what happened in their community,” explains Hansford. “It can’t just be [that] Black people are the victims of racism. They need to say the city government implemented these policies of racial terrorism against Black people and … here’s data to show how they specifically harmed us economically, criminal[ly] and educational[ly].”

Local reparations work is laying the groundwork for a national movement for reparations. Rue Simmons says Evanston was the only city to pursue a reparations program in November 2019. Since then, many more have embarked on various reparations initiatives that are collectively building momentum for the federal government to pass H.R. 40.

“Slavery was a complex institution, Jim Crow was a complex institution … They hit us intellectually, spiritually, economically, [and] educationally,” says Hansford. “The harm that was done to us wasn’t simple so the repair won’t be simple.”


Torsheta Jackson wrote this article for YES! Media.


get more stories like this via email

Some Indigenous groups in Michigan want to draw parallels to their own historic struggles and those of Palestinians in Gaza and they are doing it through powerful artwork depicting dance.

One elaborate drawing shows a Native American and Palestinian woman dancing together.

The nonprofit Citizen's Resistance at Fermi Two said the group advocates for environmental causes and safety for all people, including tribal nations.

Jesse Deer in Water, the group's community organizer, said it was important to stand up for what they believe and, in his words, to "stop all forms of oppression."

"And I can identify with it, because it's happened to my people," Deer in Water explained. "The stuff that's happening currently on the West Bank is like what happened to my people in Georgia. We had no rights, and they just came in and, like, the settlers did whatever they want."

He added the group is concerned taxpayer dollars are being used for causes contributing to the struggles of the people of Gaza and those who live around the Fermi Two nuclear plant. Legislation in Congress to send more money to Israel is expected to pass in the U.S. Senate today.

Members of True Earth, a sister organization to Citizen's Resistance at Fermi Two helped select the artwork for the solidarity campaign, including the group's social media person, Nora Berry and graphic designer Maro Beauchamps.

Beauchamps called the pictures "a perfect depiction of beauty while in struggle," and said it is important to understand how the art tells a larger story.

"Two women that are dancing together, seeing the mirror in each other of the struggle, of the shared experiences and the shared traumas," Beauchamps outlined. "We often don't even see the women that are so critical and crucial to movements of resistance."

Shunahsii Rose, also with True Earth, sees another link between the nuclear controversy and the Middle East conflict.

"Both of them are a misuse of our dollars, huge misuse of our dollars," Rose contended. "Taking the money of hard-earned people and pouring it in terrible directions that only bring harm."

A recent report details how great wealth that later made philanthropy possible around the country but most evidently in the District of Columbia, southern Maryland and northern Virginia -- commonly known as the DMV -- came at the expense of the social stability and economic success of Black residents.

Dwayne Proctor, board chair of the National Committee for Responsive Philanthropy, said older foundations likely had the best opportunity to participate in practices that were unfair and unjust to people because of the times they were in, in the social context in which they began.

"I'm hopeful that many folks will look toward their local foundations and want to know more about how they began and if they've done harm and participated in the oppression of others, like it appears to have been the case in the DMV with the foundations that are studied," Proctor said.

Proctor stressed that if readers can connect the overlaps between the social determinants of health and the necessary healing of Black families today, real and transformative conversations about repair can begin.

Katherine Ponce, research manager for special projects for the National Committee for Responsive Philanthropy, said the report tried to model what the state of California has done for its reparations task force, outlining many categories of how Black people have faced disparities in the region and how that starts.

"We talked about anti-Black media and rhetoric, housing discrimination and segregation, unemployment and hidden opportunity, and then health care, both mental and physical. We have eight case studies of foundations in the region, how their money was createdm" Ponce explained.

Ponce added the report should leave people not just knowing that big systems of oppression impact and harm people of color, but should cause people to start taking measurable actions and fix the disparities and make ties from the eight stories to their reality.