Signing up Native Americans for health insurance through the newly created Exchange will help them avoid delays in care and medical debt. Experts say it could also benefit tribes and even non-Native Americans throughout New Mexico.

If enough tribal members sign up for insurance coverage, more tribes will take over their own health care systems, experts say. That could lead to the opening of new tribal clinics throughout the state.

Some tribes already have clinics. Obamacare, which mandates the creation of exchanges in each state, lets tribes open new and existing clinics to non-Native American patients, which could help remedy rural New Mexico's longstanding physician shortage for Native Americans and other New Mexicans.

“Right now, the tribes are known for their gaming enterprises, but I believe very strongly that, in a decade, we'll be known for our health systems,” predicts Roxane Spruce Bly, director of health care and education outreach for Native American Professional Parent Resources, which is tasked with helping the state sign up Native Americans for insurance through the Exchange.

Bly says Obamacare will lead to “real change” in part by giving tribes flexibility in how they design health care systems. Tribes could even buy Exchange policies for their members.

To encourage tribes to take over or expand their own health care systems, the federal government offers tribal clinics higher reimbursement rates than non-tribal clinics. That helps tribal clinics offer doctors and other health care workers larger salaries and more incentives. And it could become a significant economic development opportunity for tribes.

The Pueblo of Jemez is already looking into the possibility of opening its tribe-run clinic to neighboring non-Native American communities.

Tribes could even open clinics in urban areas with large Native populations, Bly adds. The state needs more pediatric dentists, and, for example, Bly said a tribe could open a chain of dental clinics around the state “and make quite a bit of money.”

Bryant Furlow works on New Mexico In Depth's Native America Project, online at nativeamericaproject.com. Reach him at bryant.furlow@gmail.com or on Twitter @BryantFurlow.