[GPRI] Bush Admin Cutting Native Peoples' Health Care

[John Gallagher]

http://www.tompaine.com/articles/2007/03/21/cutting_native_peoples_health_care.php
 
Cutting Native Peoples' Health Care
Robert J. Miller 
March 21, 2007

    
Robert J. Miller is a law professor at Lewis & Clark
Law School and the chief justice of the Grand Ronde
Tribe. He is the author of Native America: Discovered
and Conquered.

American Indians have access to federally-paid health
care based on hundreds of treaties the United States
signed with Indian nations, under the accepted federal
practice of more than 100 years and as a requirement
of the trust responsibility the U.S. owes the Indian
nations to care for their welfare. Indians have not,
however, received their fair share of federal health
care, especially in light of this heightened duty. In
fact, a July 18, 2003 study by the U.S. Commission on
Civil Rights entitled “A Quiet Crisis” found that 

... the federal government’s rate of spending on
health care for Native Americans is 50 percent less
than for prisoners or Medicaid recipients, and 60
percent less than is spent annually on health care for
the average American.

Clearly, the United States is not fulfilling its
treaty and trustee responsibility to provide health
care to American Indian people. 

This issue has been brought to the forefront again by
the Bush administration’s attempts to block
reauthorization of the Indian Health Care Improvement
Act. The IHCIA was first enacted into law in 1976 and
signed by President Gerald Ford, with the intention of
bringing the level of Indian health up to that of the
general U.S. population. Since then, presidents
Carter, Reagan, George H.W. Bush and Clinton have all
signed reauthorizations.

The IHCIA expired in 2000 and has been only
temporarily funded by Congress and President George W.
Bush in the interim. Since 2001, it appears that the
White House and the Department of Justice have been
opposing its reauthorization. In late 2006, a Justice
Department “white paper” that opposed the bill was
circulated to conservative Republican Senators. (The
department now denies that anyone was authorized to
circulate it.) Some Republican senators put a hold on
the IHCIA reauthorization bill and thus prevented the
bill from being considered in the last days of the
109th Congress. 

The National Indian Health Board has called on
President Bush and Attorney General Gonzales to
withdraw this white paper and their objections to the
IHCIA, but the Republican Policy Committee has
informed senators’ offices that it will continue to
oppose reauthorization of the IHCIA, claiming that it
is “race-based” legislation. 

In a Senate hearing on March 9, 2007, Sen. Byron
Dorgan, D-N.D., slammed the white paper, taking the
White House and Justice to task for the manner in
which it was released and its contents. Republican
Sens. Craig Thomas, Wyo., and Lisa Murkowski, Alaska,
also voiced concerns about the department’s stance on
the IHCIA reauthorization and how the bill was killed
in the 109th Congress. 

In addition to questions about IHCIA reauthorization,
the Bush administration has also targeted the
elimination of health care for urban Indians (Indians
who no longer live on their tribal reservations). The
administration tried to eliminate the entire Urban
Indian Health Program from the 2007 budget but
Congress restored it. Now the administration has again
removed the entire $33 million program from the
proposed 2008 budget.

In addition to cost-saving concerns, the
administration claims to be worried that serving urban
Indians is largely a race-based action which federal
courts would disapprove of, a White House spokesman
told the Senate Indian Affairs Committee on March 8.
The alleged problem lies in the possibility of some
people who are of Indian heritage but not enrolled in
federally-recognized tribes might receiving care at
Urban Indian Health Service facilities. But this
argument is clearly specious. In fact, the definition
of an Indian to be served under the IHCIA is the same
as it has been for the past 30 years and is similar to
the definition of Indian found in President Bush’s No
Child Left Behind Act. 

The U.S. Supreme Court long ago laid to rest the idea
that government programs for the benefit—or even to
the detriment—of Indians is a racially-based
“affirmative action” issue. In 1974, the Supreme Court
stated in Morton v. Mancari that the relationship of
the United States to the Indian nations and their
citizens is a political and treaty-based relationship
and is part of the federal government’s
government-to-government relationship with Indian
tribes. Thus, congressional acts regarding tribes and
Indians are not racial or affirmative action laws but
political and diplomatic acts of the Congress
vis-à-vis the tribal governments and authorized by
Article I, section 8 of the Constitution.

On March 7, 2007, a bipartisan group of
Representatives introduced H.R. 1328—legislation to
reauthorize and even strengthen the IHCIA; a House
committee held hearings on the bill on March 14. The
Senate Committee on Indian Affairs is also preparing
its own bill to reauthorize the IHCIA. Hopefully,
Congress and the president will reauthorize the IHCIA
and restore the treaty and trust responsibility
obligations of the United States to protect the health
of its Indian citizens and to attempt to bring health
care protections for Indians up to the same standards
that all Americans enjoy.

 
 
 



    
 


 
    
  
 
 

 
 



 
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