Federal government to pay ANTHC $463 million over unpaid health costs

The federal government will pay the Alaska Native Tribal Health Consortium $463 million to settle years of litigation over money it was legally required to provide and did not.

The settlement covers contract support costs — the overhead a tribal organization takes on when it assumes delivery of federal health services. For years, the Indian Health Service reimbursed only part of what ANTHC spent, leaving the consortium to absorb the difference. The payment is $400 million in principal and roughly $63 million in interest.

What that shortfall meant depends on where you live. ANTHC serves all 229 federally recognized tribes in Alaska and runs the Alaska Native Medical Center in Anchorage, the hub of a network of village clinics, subregional clinics, and regional hospitals. In much of rural Alaska, that system is not one option among several — it is the only provider. Money spent covering a federal obligation was money not spent on care, staff, or facilities.

The settlement follows the U.S. Supreme Court's decision in Becerra v. San Carlos Apache Tribe, which held that tribal organizations are entitled to full reimbursement of those costs.

Sen. Lisa Murkowski, who chairs the Senate Committee on Indian Affairs, called the tribal health system "a lifeline" and said the money ends years of costly litigation.