Oral Argument: Becerra v. San Carlos Apache Tribe | Case No. 23-250 | Date Argued: 3/25/24 | Date Decided: 6/6/24

Case consolidated with Becerra v. Northern Arapaho Tribe, Case No. 23-253.

Link to Docket: Here.

Background:

The Indian Self-Determination and Education Assistance Act, 25 U.S.C. 5301 et seq., permits eligible Indian tribes to contract with the federal government to assume responsibility for federal health care programs administered for the benefit of Indians. Upon entering into the contract, a tribe is entitled to the appropriated funds that the Indian Health Service (IHS) would have otherwise allocated to the federal program. 25 U.S.C. 5325(a)(1). The Act also requires IHS to pay "contract support costs"-funds "added to" that appropriated amount to cover the costs of activities the tribe must undertake to operate the transferred program, but which either "normally are not carried on" by IHS when acting as program operator, or which IHS would have "provided * * * from resources other than" the appropriated funds transferred under the contract. 25 U.S.C. 5325(a)(2). Separately, contracting tribes are permitted to collect payment from third-party payors-like private insurers, Medicare, and Medicaid-when they provide health care services to covered individuals.

Question Presented: Whether IHS must pay "contract support costs" not only to support IHS-funded activities, but also to support the tribe's expenditure of income collected from third parties.

Holding: The Indian Self-Determination and Education Assistance Act requires the Indian Health Service to pay the contract support costs that a tribe incurs when it collects and spends program income (i.e., revenue from third-party payers like Medicare, Medicaid, and private insurers) to further the functions, services, activities, and programs transferred to it from IHS in a self-determination contract.

Result: Affirmed.

Voting Breakdown: 5-4. Chief Justice Roberts delivered the opinion of the Court, in which Justices Sotomayor, Kagan, Gorsuch, and Jackson joined. Justice Kavanaugh filed a dissenting opinion, in which Justices Thomas, Alito, and Barrett joined.

Link to Opinion: Here.

Oral Advocates:

• For Petitioner: Caroline A. Flynn, Assistant to the Solicitor General, Department of Justice, Washington, D.C.
• For Respondent in 23-253: Adam G. Unikowsky, Washington, D.C.
• For Respondent in 23-250: Lloyd B. Miller, Washington, D.C.