Rep. Kevin Killer is fighting for re-election in District 27. He's leading the mighty get-out-the-vote charge on the Pine Ridge Reservation that could tip the balance in the U.S. Senate race.

And on top of that, he's proposing a big tribal sovereignty idea: let South Dakota's tribes leapfrog the state and set up their own health insurance exchange and expansion!

“If I am re-elected I plan on introducing a bill that would ask the state to delegate their authority to tribes on the reservation under the Affordable Care Act and allow for tribes to set up their own healthcare exchanges and to expand Medicaid to tribal citizens,” said Killer.

...“If the state of South Dakota wants to opt out of certain parts of the Affordable Care Act based of principle that is their right. What I want to do is to allow for tribes to partner with each other to set up these exchanges to help with economic development and to provide coverage to their members,” said Killer [Brandon Ecoffey, "Indian Lawmaker Kevin Killer Makes Big Plans," Indianz.com, 2014.10.27].

But what about the Indian Health Service? Ecoffey explains that Congress has hamstrung the IHS and Bureau of Indian Affairs budgets, leaving tribes reaching for alternatives. Medicaid and private insurance revenue can keep IHS facilities running. Plus, IHS doesn't cover everything that Medicaid and private insurance do. Let the tribes extend those benefits, and tribal members get access to better health care.

But would our ACA-averse Republican Legislature let the tribes exercise their sovereignty to take advantage of federal services that the SDGOP has denied the rest of South Dakota?

It sounds like a heck of an idea, Rep. Killer! I look forward to your testing your colleagues' commitment to tribal sovereignty and health care this winter.

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