RESUMO
For years, the federal government has failed to uphold its promises to provide health care to Native Americans. These promises are echoed in treaties, the Constitution, and judicially-created law. As a result of this breach of promise and chronically underfunding, there are significant health disparities between indigenous populations and other Americans. In a recent 2020 case, McGirt v. Oklahoma, the U.S. Supreme Court held that both the federal government and individual states must follow the terms of a treaty made with a tribe, encouraging the possibility of direct health care funding. This reform, however, means little without tribal sovereignty and self-determination, which give dignity and decisionmaking capabilities back to a group that has long been without them. This Note explores two examples of self-determination in Native American health care, the Alaskan Native health care system and the recent vaccine rollout, proposing a framework for increasing self-determination in health care to provide support for funding reform, which becomes increasingly necessary as Native Americans continue to struggle to access health care.
