Health care reauthorization act fails
Abortion amendment ‘dominated and clouded the whole debate’
By Jerry Reynolds
Story Published: Oct 3, 2008
WASHINGTON – Lead organizations and lobbyists have admitted the defeat of efforts to reauthorize the Indian Health Care Improvement Act.
Declaring efforts to enact the bill “shut down” in Congress, the National Indian Health Board stated on its Web site Sept. 29 that it will continue to pursue strategies for enacting the reauthorization bill during what little remains of the current 110th Congress. But already by the evening of Sept. 26, a longtime lobbyist on Indian health issues, speaking on condition of anonymity when anything could still happen, said key congressional committee staff had put its chances of passing at slim to none.
By then, as recounted by NIHB, attempts to attach the bill (H.R. 1328 in the House of Representatives) to a “continuing resolution” on the budget – i.e., a measure to fund the federal government until Congress can pass a national budget – had faltered.
The bill’s chances didn’t improve over the weekend of Sept. 27 – 28. In the process of trying to move smaller parts of a larger bill that has faltered through the legislative system separately, the bill’s advocates tried to strip out Title II of the larger bill – the section providing enhanced Native access to Medicare, Medicaid and the State Children’s Health Insurance Program – as a stand-alone bill. “Kind of like taking apart an automobile,” as Blackfeet lobbyist Tom Rodgers of Carlyle Consulting described it. But when that process gets started, he said, it’s not long before the separate parts add up to less than the sum of the whole. (If this is a way to merge Indian Health Care with Medicare, Medicaid and the State Children's Health Insurance program, that ain't going to work - Medicare is so corrupt, I don't think it is clean upable; not to mention Tribes would loose all control over health care - nope we're not being told something here?? and I believe Bush recently did sign a bill that sent 2 billion into Indian Country for Health care and law enforcement - although I could be wrong on that amount - and if you think Indian Health Care is bad - boy, seniors on Medicare have some real limited coverage - in fact most Doctors have been complaining about this for years - in order to make money, yep, that's why they're in this, they can only take 5 minutes with each patient per office visit - and they run a very large number of patients through - I don't know, I don't think government does well in the Health Care area and Medicare etc would be less Indian friendly)
“Unfortunately,” NIHB summarized on its Web site (http://www.nihb.org/), “House [l]eadership was not able to fund the first five years of the bill in an amount of $53 million.” (huh, but they found 800 bn for Wall Street - well that makes you feel warm and fuzzy all over! I think the true motivation is to try and get Indian Health Care covered under the Federal Medicare stuff - as in lumping us all into the greater U.S. health pot - I have to wonder why they would want this? You KNOW it's not for the Indians - remember Health Care is a Treaty right. Oh, what's the use, apparently the brick wall is up and knocking ones head against it, is just plain not healthy, no health care to cover any injuries!)
That was for the proposed stand-alone bill comprised of Title II. Though the Congressional Budget Office had estimated the original reauthorization bill to cost $129 million over 10 years, funding had become a problem for the bill as Congress arranged the well-known $700 billion bailout bill for the financial credit system, along with at least $1 billion in tax giveaways and a $25 billion loan package for Detroit automakers. (Yep, see Indian Health Care was just plain pushed aside - what was that about marginalizing Freedmen!)
On Sept. 24, as conditions in credit access built toward the $700 billion crisis, Rep. Tom Cole, R-Okla., enrolled Chickasaw, urged passage of H.R. 1328. Budgetary pressures in 2009 could work against even modest new expenditures, he warned.
But House leadership (you know who this is, Frank and Pelosi) had decided not to offer the bill for a vote in the first instance because of the abortion issue. An amendment forbidding the use of federal funds to pay for abortions under the reauthorization had been added to the Senate version of the bill by Sen. David Vitter, R-La. House Republicans, despite what NIHB calls Indian country’s consistent position that abortion is inappropriate to an Indian health bill and already restricted under current law on federal funding, now wanted to attach the Vitter amendment to the House version.
In addition, NIHB relates, the National Right to Life Committee threatened to “score” votes on the bill as pro- or anti-abortion if the amendment were not permitted. (score votes?) Because the committee would score a vote on the amendment in any case, the political calculus boiled down to this for House leadership: to bring the bill forward would be to register a vote on abortion little more than a month before every member of the House faced the voters on Nov. 4. (tell a sick Indian kid - congress didn't want to *score* a vote on abortion, so he can't go to the doctor! This is just plain ridicules)
Lawmakers are generally allergic to making choices so close to an election, Rodgers explained. The abortion amendment “dominated and clouded the whole debate,” he added. (abortion needs to get completely out of the federal public arena!)
He cited another reason for the bill’s setback. “Indian country needs to have more allies on the [House] Energy and Commerce Committee. It is basically an urban committee which does not reflect historical ties to Indian country.” (what!! This is health care - not a Wall Street bailout - this sounds like a subtle request for a campaign donation! Remember Acorn!!)
Indian country, especially health care advocates and professionals, must work to address the problem substantively and procedurally as Nov. 4 approaches, he said. “That’s what elections are for. ... You do that by embracing your friends and punishing your enemies, and that can only be done by hard work.” (punishing your enemies - hmmmm, another congressional something or other - are Indians still enemies? - Congress needs to come into the 21st Century - or are we caught in the middle of a party feud!)
Other principal committees of jurisdiction on the bill – House Natural Resources under Rep. Nick Rahall, D-W.Va.; Senate Indian Affairs under Sen. Byron Dorgan, D-N.D.; and Senate Finance under Sen. Max Baucus, D-Mont. – performed “exceptionally well” on the bill’s behalf, Rodgers said. (apparently they don't have any friends on that committee either! Good grief how many committees does this thing have to go through! Was that in the Treaty - basic health care can be delayed because Indians don't have firends on key committees!)
As the 110th Congress approached recess, the failure of the Indian Health Care Improvement Act reauthorization left an angry mood among its advocates. “They’re bitter, very bitter,” said Gregory Smith, of Smith and Brown-Yazzie LLP in Washington, D.C. The National Congress of American Indians had made the bill its top legislative priority. NIHB, the National Council of Urban Indian Health, the National Steering Committee on Reauthorization of the Indian Health Care Improvement Act, the California Rural Indian Health Board, a host of other organizations and tribes, tribal leaders and individual Native people, lawmakers and legislative staff and lobbyists by the score have poured their efforts into refining the bill and passing it, many of them for years running.
They’ll try again next year, Rodgers said, with new strategies for the new political landscape of the next Congress.
(Well, I hope no one gets sick!)