The United States federal government’s relationship with Native American tribes has long been tenuous. Despite years of unjust and inhumane treatment of Native Americans by the government, Congress has attempted to rectify or limit the government’s harm to Native American people but has fallen short of upholding all agreements intended to improve United States-tribal relations. In particular, the government has not always followed treaties between the government and tribes, and the United States Supreme Court has failed to protect Native American rights in many cases. Central to this issue is the 1868 Treaty of Fort Laramie, in which the United States government agreed to provide physician-led healthcare to tribes, including the Rosebud Sioux Tribe. Prior to the treaty’s execution, the Court held that the government has a unique, general trust responsibility to tribes. Since the treaty’s execution, Congress has passed legislation on the implementation of tribal healthcare. The Eighth Circuit has concluded that the United States has a trust duty to provide healthcare to Native Americans, while the Ninth Circuit has concluded that the United States has no such duty. The Supreme Court has never expressly addressed this question.
This Note examines Supreme Court precedent to create an analytical framework for determining when trust duties attach to the government in its dealings with tribes in the healthcare context. This Note concludes that, considering this framework, the current composition of the Supreme Court, and policy concerns surrounding racial justice, the Court will likely hold that the United States has a trust duty to provide healthcare to Native Americans.
"To Trust or Not to Trust: Native American Healthcare Improvement in the Supreme Court’s Hands,"
Georgia Law Review: Vol. 56:
3, Article 8.
Available at: https://digitalcommons.law.uga.edu/glr/vol56/iss3/8