WASHINGTON – National Indian organizations lost no time calling on Congress to reauthorize the Indian Health Care Improvement Act following the recent introduction of House Bill 5312 in the House of Representatives. The 1976 law was last updated in 1992; advocates at a May 16 news conference said reauthorization will help to modernize health care for the nation’s least healthy population – Native people – by addressing elder care, mental health, diabetes, health care delivery and other urgent matters with a new flexibility.
Rep. Don Young, R-Alaska, introduced the bill. He is a powerful backer in the House; and the only Indian in Congress, Chickasaw Rep. Tom Cole, R-Okla., has spoken out for reauthorization, as have other members of the Congressional Native American Caucus. Jacqueline Johnson, executive director of the National Congress of American Indians, responded to a question at the news conference on Cole’s role by saying Indian country will rely on him to help move the bill through the House committee structure.
The Resources and Energy and Commerce committees have concurrent jurisdiction over the reauthorization bill in the House. The Senate version of the bill, S. 1057, is before the Health, Education, Labor and Pensions Committee. That is a lot of committee to clear in a legislative cycle shortened by midterm congressional elections in November, and it will have to be done, as of this writing, without an “administration views” letter from the White House. The letter is an ordinary, but inessential, part of the legislative process. Issuing an administration views letter is at the discretion of President George W. Bush.
“You know, we’ve been looking forward to that administrative letter for the last year or more, and have yet to receive the administration’s letter,” Johnson said. “And what we’re saying to Congress is, there’s been plenty of conversations with the administration. We know where their concerns are, we haven’t received the letter, whether it be [Office of Management and Budget] or Department of Justice who are holding up the letter. Bottom line is, let’s move forward. Congress is the decision-making body that this country relies upon. We need Congress to take action and Congress to do something about this, and move this forward.” She called on House committees to move the bill “straight to mark-up” – straight to a committee vote, without an intervening revisionary process – because of all the work already done on it.
Reauthorization of the IHCIA is in its sixth year before Congress. In 2004, as the 108th Congress entered its second session, the Senate Committee on Indian Affairs and the Department of Health and Human Services mounted a serious effort to pass a reauthorization into law. But the effort faltered.
Among the sticking points that still remain for reauthorization, according to National Indian Health Board Executive Director Stacy Bohlen, are the insistence of elected tribal leaders on a steering committee; that reauthorization cause “no regression” from current health care, meaning “we have to be very careful about how the law is laid out, and ensure that basic quality of care is assured for Indian people”; the national burdens of war and a federal budget deficit; the government’s worries over liability; the highly technical language around references in the reauthorization to Medicare and Medicaid; and the comparatively small number of American Indians in the country.
“This problem will not be solved alone,” Bohlen said, recognizing a host of Native and non-Indian national health organizations that have agreed to support the reauthorization.
