After reviewing a feasibility report, the department is optimistic that the tribe can sustain its own Medicaid program, even if the study was not as optimistic. The study has not yet been released, though it is complete and is under review by the U.S. Department of Health and Human Services currently.
It will go to Congress for review March 23.
"Basically, what they indicated was if the Navajo Nation wanted to do it, it could do it," said Larry Curley, executive director of the Navajo Nation Department of Health. "The Navajo Nation is moving ahead with this."
About five years ago, the tribe began looking into creating its own Medicaid program because of the issues some of its members had with other health care programs available in the three states that the it overlaps New Mexico, Arizona, and Utah.
While more than 100,000 members of the tribe are eligible for Medicaid, many of them do not take advantage of the services because of the complications that frequently accompany them, Curley said.
Members often have to travel long distances or go to certain clinics to receive the services, he said.
Additionally, all three states are pursuing their own versions of Medicaid within their state boundaries, which creates issues for Navajo who live in one state but sometimes are closer to services in another.
The tribe asked that a feasibility study be done, to see how viable its own Medicaid system would be. Though a lack of funding stalled the study, the passage of the Indian Health Care Improvement Act in 2010 made the study possible. The act was passed when U.S. President Barack Obama signed the Patient Protection and Affordable Care Act in March that year.
The study was a six-month study that came to an end last year, though Curley did not know how much it cost, he said.
The study assumed that the tribe's Medicaid system that would serve Navajo within the tribe's geographic boundaries would alleviate some of that confusion.
"It would just be simpler for us. We wouldn't have to face the different rules that different states have," said Erny Zah, spokesman for the Office of the President and Vice President of the Navajo Nation.
However, the process would not be simple.
To put into place the infrastructure, technology and people needed to make the program work, the cost currently is estimated to be between $100 million and $120 million, Curley said, though he noted that the study said it was a very rough number.
"It won't be billions," he said.
It also would not be for several years that the program would get started, Curley said, though he sees it definitely working.
"I have a fantastic belief in Indian peoples that they can do what they believe they can do," Curley said, noting that this system will be able to incorporate traditional medicine and will be a more culturally sensitive system. "It will be successful."
Other leaders have not been quite as confident. New Mexico politicians in August last year expressed doubts about both the state's and the tribe's plans for Medicaid during a meeting in Shiprock.
"If we don't do a lot of planning, there's going to be a lot of collateral damage," said David Foster, then chairman of the Health Care Committee for the Association of Commerce and Industry of New Mexico.
The Navajo Nation president and vice president both have abstained comment for the time being, Zah said Friday, because they have not yet reviewed the study. They are hopeful though.
"We understand it would be a lot," Zah said. "But we're definitely capable."