WASHINGTON – Rep. Frank Pallone made it clear June 7 that despite the best efforts of the new Democratic majority to position them for passage, the Indian Health Care Improvement Act amendments of 2007 are not likely to become law quickly or easily in the current 110th Congress.
Chairing the health subcommittee of the Energy and Commerce Committee in the House of Representatives, Pallone engaged in extensive dialogue with IHS Director Dr. Charles Grim on the comment process that has held up previous versions of the bill until late in the two previous Congresses, leading to the bills’ demise. In both cases, time ran out on the heavily detailed legislation during the hectic proceedings that characterize the end of any two-year Congress. Pallone, D-N.J., and like-minded lawmakers have tried to guard against that this time around by moving the bill (informally known as the Indian health care reauthorization) through the major committees of jurisdiction early in the 110th. Grim could provide no confidence that the administration will match the dispatch of Congress in providing comments back on the bill. But he assured Pallone, who introduced the bill earlier this year, that he won’t be kept waiting for comments until the last hour.
”As you heard me say in my opening statement,” Pallone began, ”I’m very frustrated over the fact that we – we, I say ‘we’ collectively, the tribes, myself, many other members [of Congress] – have been working on this legislation essentially for more than seven years, and we haven’t been successful. And I’m not trying to point the finger because I’m sure everybody can take some of the blame. But it does seem that every time at the end of a two-year session, when we’re close to getting something done, that we get the administration coming in with some new objections. And it might be from HHS [Department of Health and Human Services]; it might be from the Department of Justice. And that’s certainly what happened last year, at the end of the last Congress. And of course, you know, what I’m trying to do is avoid that this year. That’s why we got it out of Resources [House Committee on Natural Resources]; that’s why we’re here early. And as I said before … I would really like to report a bill out of even the subcommittee that the president could sign.
”So you’ve got to give me some help here. First of all, I’d like to have a commitment from you that the administration will work with us in good faith to reauthorize the bill this year, in 2007, if you would make that commitment.”
Grim responded: ”I’m not sure about 2007, but I can tell you that we’re very, very close within the department to getting comments on the bill to you. They’re going through some final stages of clearances right now, and we have made comments on the prior Senate bill that I think gave a lot of guidance, and a number of those things were changed in the bill that you introduced. … They won’t come in the twelfth hour, at the end of the second year. …”
Before Grim left the witness table after questioning from other committee members, Pallone returned to the theme.
”It’s obvious that there are a lot of disagreements with the administration on this bill. And I would like to get those all on the table, and try to iron them out, and see that we can come to a consensus. Because we really don’t want – we want a bill that’s going to pass, that’s going to, you know, come to conference with the Senate; go to the president.
”I mean, there are going to be differences, and we’d like to work them out. But we can’t work them out unless we have them all on the table. So I appreciate the fact that you’re going to try to get us all of these objections as well as look at support, you know, within the next month, and also that you’re going to try to be sort of a clearinghouse for, you know, other departments or agencies, because that’s just as important. So thank you again. We’ve got a lot of work to do.”
After the hearing, which featured more testimony and questioning than usual on urban Indian health care, Ralph Forquera confirmed that earlier amended words acknowledging urban Indians as a responsibility of Indian health care programs have been taken out of the current Indian Health Care Improvement Act amendments.
”So we’ve been working with staff and we’ve been working with members [of Congress] to try and make sure that that gets reinstated in the bill,” said Forquera, executive director of the Seattle Indian Health Board. ”I have confidence that it will, but until it’s actually there, we’ll continue to keep an eye on it. … We’ll continue to bird-dog it until we actually get it in. Everyone that we’ve talked to who has the capacity to be able to fix that has said that they will. We’ll hold them to that in some fashion.”
Forquera said efforts are ongoing to include language in the ”findings” section of the bill to the effect that urban Indian health care is based by intent of Congress on political, rather than racial, distinctions. In a supposed ”white paper” circulated to kill the reauthorization last November, at the end of the 109th Congress, a Justice Department staff member raised doubts among hard-right Republicans about the constitutionality of health care for Indians and urban Indians. A constitutional scholar has since testified before Congress that constitutional doubts in the matter are unfounded where congressional intent is clear.
