For the first time, Utah Medicaid can help pay for Native American traditional healing

SALT LAKE CITY — For generations, Native American communities have relied on traditional healing practices that care for more than just the physical body. Now, for the first time in Utah, Medicaid can help pay for some of those services.

The federal government approved Utah's Traditional Healing Demonstration, allowing Medicaid reimbursement for certain traditional health care practices provided through Indian Health Service facilities, tribal health programs and urban Indian health organizations.

For Matt Poss, executive director of the Urban Indian Center of Salt Lake, the change represents years of work to recognize something Native communities have long understood: Health care is about more than doctor's appointments and prescriptions.

"There's a lot of different pathways to become kind of a stronger, healthier person," Poss told KSL.

What does traditional healing actually look like?

Traditional healing takes many forms, Poss said, often depending on a person's tribe and cultural background.

Practices can include sweat lodge ceremonies, talking circles, the use of traditional plants and other ceremonies passed down through generations. They are often led by healers recognized within their communities for their knowledge of tribal customs and traditions.

Some practices address physical ailments, while others focus on emotional, mental or spiritual well-being.

"Really, it's kind of a traditional medicine approach that balances against Western medicine," Poss explained.

He emphasized that these practices aren't necessarily intended to replace conventional medical treatment.

"They all complement one another," he said.

Poss pointed to the Native American medicine wheel, which recognizes different aspects of well-being, including the mind, body and spirit. For the people his organization serves, traditional healing can offer another way to work through difficult experiences, find balance or reconnect with cultural traditions.

The federal Centers for Medicare and Medicaid Services cited research suggesting traditional practices can help improve certain mental health symptoms, substance use recovery outcomes and overall quality of life when used alongside conventional care.

The specific practices eligible for reimbursement must meet program requirements and be provided through qualifying facilities and practitioners.

Bringing medicine back to the people

At the Urban Indian Center of Salt Lake, traditional healing isn't something new.

Poss said the organization, formerly known as the Indian Walk-In Center, has offered sweat lodge ceremonies for at least 15 years. But during the COVID-19 pandemic, those gatherings came to a halt.

The center's sweat lodge remained largely dormant for approximately four or five years until a traditional healer from the Ute Tribe, Henry Howell, helped bring it back.

"He basically came on site one day and said, 'Hey, I'd love to get this going again for you and bring medicine to the people,'" Poss recalled.

With Howell's help, the center revived the program, which Poss said has now been operating again for about a year and a half. The return of the sweat lodge highlighted the importance of preserving traditional practices and making them available to Native people who may not have easy access to ceremonies within their own tribal communities, Poss said.

But providing those services comes with a financial challenge.

"For us as a nonprofit, we always want to provide this service, right? But there's a lack of funding behind it," Poss said.

Over the years, the center has relied on grants, foundations and other funding sources to keep cultural and healing programs available. The Medicaid approval establishes another potential source of financial support for eligible services.

Years of work behind the approval

The approval follows efforts by Utah lawmakers, tribal leaders and Native health organizations to expand access to traditional healing.

In 2024, Utah lawmakers passed SB181, directing the state's Department of Health and Human Services to seek federal authorization for Medicaid coverage of traditional healing services.

Poss said the Urban Indian Center and Utah tribes have been involved in discussions and advocacy surrounding the proposal for approximately three to four years.

The latest approval makes Utah one of six states authorized to use Medicaid funding for traditional Native healing practices. Arizona, California, New Mexico and Oregon received federal approvals in 2024, with Utah and Maine joining them this fall.

One significant part of Utah's approval is the inclusion of urban Indian health organizations.

For Native Americans living away from reservations or tribal communities, those organizations can help maintain access to cultural traditions as well as medical and behavioral health services.

However, federal officials did not approve everything Utah requested.

The state sought a 100% federal Medicaid matching rate for qualifying traditional healing services delivered through urban Indian organizations, similar to the federal funding available for eligible services provided through Indian Health Service and tribal facilities.

Instead, services delivered through urban Indian organizations will receive the state's otherwise applicable federal matching rate.

That means urban facilities remain eligible to participate in the program, but the federal government will not cover the entire state expenditure at those facilities under the same arrangement available to qualifying tribal and Indian Health Service providers.

Although the authorization took effect in October, it has not yet been independently confirmed whether Medicaid payments for traditional healing services have begun at the Urban Indian Center.

Poss said the approval itself is an important acknowledgment of years of advocacy by Native communities.

"It just shows that there's meaningful work behind it," he said.

A growing Native community in Utah

The policy change comes as Utah's Native American population continues to grow. According to U.S. Census Bureau estimates, the number of Utahns identifying as American Indian or Alaska Native, either alone or in combination with another race, increased from just over 114,000 in 2020 to just over 133,000 in 2025.

Poss estimated that approximately 5% to 10% of the state's Native population visits the Urban Indian Center each year. Those visits can involve medical appointments, behavioral health care, cultural activities or community gatherings.

The center has served Utah's Native population for 52 years, and Poss said the organization is now preparing for another major change.

Its aging community center, housed in a building dating back to the late 1940s, is expected to be rebuilt as part of a multiyear effort to expand services and strengthen the organization's community presence.

The nonprofit has also announced plans to consolidate its three locations into one central facility.

For Poss, the developments reflect a broader goal of helping Native Utahns maintain a connection to their communities while making additional resources available to future generations.

He said the Medicaid approval demonstrates what can happen when tribal leaders, health organizations and community advocates work toward a shared goal.

"I'm really proud of the Native community for kind of standing behind it," Poss said.

And as the center prepares for its next chapter, he believes that spirit of cooperation will remain essential.

"There's more power in collaboration, I think," Poss said.

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