Aila Hoss, Toward Tribal Health Sovereignty, 2022 Wis. L. Rev. 413 (2022).
Abstract
Although federal law defines Tribal sovereignty as the “right . . . [of Tribes] to make their own laws and be ruled by them,” Tribes have been exercising their sovereign powers since long before the establishment of the United States. For the purposes of this Essay, I discuss Tribal health sovereignty in the context of a Tribe’s ability to make, implement, and enforce its own health programs and policies based on its culture and values. Tribal health sovereignty must also include adequate oversight and accountability over federal Indian health obligations. This, of course, is just a snapshot of the ways in which a Tribe may exercise its health sovereignty. I argue that reforms in federal Indian health policy are essential to securing Tribal health sovereignty.
This Essay begins by briefly describing Tribal governments and their relationships with the federal government under federal law. It then describes the inherent authority of Tribes to engage in public health activities. Next, this Essay describes Indian health systems under existing law, arguing for more Tribal-driven health programming and highlighting the legal barriers to achieving this. This Essay concludes by making specific, concrete recommendations for reforms under federal law and describes how these reforms can promote Tribal health sovereignty.
