On these ratings where health insurance or quality of health is concerned, do they count the Native American health care systems per the number of NA people as covered ?

I have an Arapaho friend who never had health insurance due to using their Indian hospital in Clinton. He once told me that the cost for his kids being born was a tank of gas in the car.

I wonder if our bad ratings in Oklahoma health care is skewed by the Indian Nations having their own health systems ? Are the individuals being counted in the surveys ?