The state of Washington is helping Native Americans access health care after decades of barriers.

Health insurers have made it difficult for tribal members to get care covered, despite state and federal laws that bar this.

Vicki Lowe is the executive director of the American Indian Health Commission, which has led efforts to remove hurdles for Native Americans.

She said health insurers would try to make tribal clinics charge out-of-network rates, and wouldn't honor their referrals.

However, the Washington State Office of the Insurance Commissioner has come out with guidance to prevent this.

"Not only will tribes have more money to help pay for services for their tribal members, tribal members will get care in a more timely manner," said Lowe. "So those two things just are really important, and insurance companies have been a barrier for that for decades."

Washington is among the first states to move forward with guidance for insurers and also enforcement of the law so that insurers will stop putting up roadblocks for tribal members to get care in the state.

Todd Dixon is the deputy commissioner for consumer protection and the tribal liaison for the Office of the Insurance Commissioner.

He said one reason for releasing the guidance was that the agency has seen an uptick in complaints - the number one compliant typically coming from billing managers at clinics.

"It says, 'Hey, we have an enrolled member. He or she was seen at our clinic. We billed the insurance company. They said we're out of network and so "we're only paying 60%." And then they send a bill to the enrolled member,'" said Dixon. "It's not how it works."

The Insurance Commissioner's office has been sending notices to insurers who violate protections for Native Americans.

Lowe said before they got involved, tribes fighting with insurers on their own were getting them nowhere. But it's different with the state backing them.

"Knowing that if somebody violates these laws that they're going to get that outreach from the insurance commissioner and that they have 15 days to respond," said Dixon. "Where if a tribe asked them, they would maybe not respond or respond in some convoluted way - it's a power shift to really have the state agency behind this."

A Montana-based Indigenous advocacy group said it is increasing membership this year in a new way, with a traveling conference.

Western Native Voice on Tuesday held the last of about a dozen conferences it has hosted since March in tribal communities across Montana. The group offers programs to attendees that focus on leadership development, civic engagement and education, and public policy advocacy.

Denise Juneau, former Montana state superintendent of public instruction and a conference keynote speaker, said Native legislators made a lot of headway in this year's session.

"There was a sense of pride in seeing what got accomplished through the 12 Native legislators who got elected from all these different communities," Juneau explained. "I think really a glimmer of hope about what can happen when people get engaged."

Bills passing in 2025 included updates to the Montana Indian Child Welfare Act and a new approach to the Missing and Murdered Indigenous Persons crisis, as well as reauthorization of Native language preservation programs and formal recognition of Indigenous Peoples Day.

Juneau, an enrolled member of the Mandan Hidatsa Tribes of North Dakota, credits her own success in part to growing up with parents in the state Legislature and tribal leadership.

"Being in those seats of power and speaking truth to power, and being engaged at that level really makes a difference for your community, for your state, for the country and for the people who are around you," Juneau recounted.

She encouraged people to get involved at any level, from ensuring your family is registered to vote to running for office.

Shane Doyle, executive director of the nonprofit coalition Yellowstone Peoples and a member of the Apsáalooke Nation, said there is a common misconception tribes across Montana were historically in conflict, when evidence shows they were largely friendly.

"Despite the enormous and remarkable language diversity here in Montana, the tribes were all able to coalesce over generations and create their own sign language," Doyle noted. "It just is a testimony to their stable relations."


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The FBI has said it will add resources in 10 states including New Mexico to tackle unresolved crimes, with a focus on those related to missing and murdered indigenous persons but not everyone is convinced it will have a significant effect.

The agency said 60 agents will be deployed to Albuquerque to investigate unsolved crimes.

Darlene Gomez, a tribal attorney, has spent her career advocating for missing and murdered Indigenous women. When it comes to investigations, she said accountability can be lacking.

"When the Department of Justice or President Trump enacts legislation or (a) special task force, we very rarely see any of the data that comes out of what those task forces were supposed to accomplish," Gomez noted.

Prior to the FBI announcement, the Trump administration scrubbed an online report from the Not Invisible Act Commission, mandated by bipartisan legislation and signed into law by President Donald Trump during his first term.

In the U.S., less than 4% of the population identifies as Native American but it is disproportionately affected by violence, domestic abuse and mental health disorders.

Gomez has a friend who's been missing for 24 years, so she is encouraged New Mexico recently adopted the "Turquoise Alert," a system to help locate missing Indigenous people, similar to an Amber Alert for missing children and already operational in California, Colorado and Washington. Nonetheless, Gomez worries New Mexico is backsliding on its commitment to locate the missing.

"I feel like New Mexico was once the premiere state in the country working on murdered, missing, Indigenous women and relative topics, and we were making huge, significant strides," Gomez explained. "Now we are down at the bottom again."

Recent numbers are not available, but as of 2019, homicide was the third most common cause of death for Native American girls ages 15-19 and 20-24. The FBI's National Crime Information Center showed more than 10,000 entries for missing Indigenous people in 2023, a number believed to be inaccurately low.

Protections for Indigenous rock art in Wyoming are in limbo after state lawmakers and the Trump administration took potentially conflicting actions related to them.

Senate File 91, which handily passed the state Legislature, increased the penalties for any kind of petroglyph or pictograph site destruction to a $750 fine and up to six months in prison.

The measure moved forward as the U.S. Department of the Interior fast-tracked energy projects through a decades-old legal review of such sites.

Crystal C'Bearing, tribal historic preservation officer for the Northern Arapaho Tribe, said she used to have 30 days to comment on a project, but now has seven.

"In terms of tribes, our sacred sites and our places of significance, that's our history on the ground," C'Bearing pointed out. "It's not in books, it's on the land. So it's really important for tribes to have that voice in there to protect those sites."

The original Wyoming bill included nearly $500,000 for the state's Department of State Parks and Cultural Resources to survey and make 3D models of Wyoming's petroglyphs but it was ultimately cut.

According to a 2024 "State of the Art" report, of the nearly 1,100 Indigenous rock art sites across Wyoming, about a quarter have been vandalized or defaced.

Beyond Wyoming's borders, C'Bearing noted her office provides legally mandated consultation on any projects in her tribe's ancestral migratory territory, which includes portions of 17 states. She added she takes on hundreds of requests.

"That 30-day window was barely enough time," C'Bearing contended. "Now we have to kind of prioritize those so we can push them through. But it's a challenge."

C'Bearing emphasized the office is allowed to request more time to review projects, giving consultants some leeway.


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