FCNL: Native American Legislative Update (07/14/04)

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FCNL NATIVE AMERICAN LEGISLATIVE UPDATE (07/14/04)

 

URGE CONGRESS TO IMPROVE INDIAN HEALTH CARE: The best way to upgrade and

modernize health care for Native Americans is for Congress to reauthorize

the Indian Health Care Improvement Act (IHCIA). Reauthorization, which has

solid tribal and bi-partisan congressional support, permits program changes

and expansions to the Indian health care delivery system. However, the

Administration is " sitting " on the House and Senate updates to this Act.

Progress is being impeded, even though (1) the Act deals with health matters

of life and death importance to American Indians and Alaska Natives and (2)

Administration officials have stated repeatedly, year after year, that they

understand this is the number one health priority for Indian Country.

 

Where is reauthorization stalled? The Administration still has not provided

its views on the reauthorization bills S 556 and HR 2440. When this critical

step is finished, advocates must help the reauthorization legislation make

it through five committees in the short time left in this Congress.

Advocates, Congress, tribes, and the Department of Health and Human Services

have worked on this reauthorization for five years. The need for it should

not be forgotten during these hectic last weeks of the 108th Congress.

 

ACTION: Contact your senators and representative and say it is imperative to

reauthorize the Indian Health Care Improvement Act (S 556 and HR 2440), the

foundation for health services for Native Americans which assures access to

and the availability of services. Times have changed since this law was

last reauthorized and medicine has changed. Revisions to the law will allow

the health care delivery system to be more responsive to real world tribal

needs. Time is running out to pass this high priority piece of legislation

which has been endorsed by tribes from coast to coast. Tell your senators

and representative that the Act has not been reauthorized since 1992 and the

administration can still expedite passage of this legislation if it makes it

a top concern.

 

CONTACTING YOUR ELECTED OFFICIALS IS EASY: Start with the sample letter

posted in our Legislative Action Center, personalize the language, then

email or fax your message directly from our site. You can also print it out

and mail it. To view the sample letter, click, <http://capwiz

com/fconl/issues/alert/?alertid=6127016 & type=CO>

and then enter your zip code.

 

BACKGROUND: Modernizing and improving the health care system for American

Indians and Alaska Native communities is essential. Without updates to

IHCIA, it is hard to keep pace with changes in community and tribal delivery

of health care or with needs for new directions and emphases such as

behavioral health. Programs and projects to address all facets of health

care-acute, chronic, behavioral, preventative--depend on reauthorization.

The original law was passed in 1976 to assure a comprehensive and integrated

approach because the health status of native peoples ranked far below that

of the general population. It still does; the life span of native peoples

is six years shorter. Native Americans have higher mortality rates than the

white population from birth on; for example, there is a higher rate of

Sudden Infant Death Syndrome. They have a 420% higher death rate from

diabetes than the general population. To see the Spring 2004 Indian Report

click here <http://www.fc!

nl.org/now/indian/04spring_Indian_Report.pdf>. The intent of the original

law was to rapidly bring the tribes up to parity but that did not happen.

Among the avenues for improving health care are expanding services and clean

water programs, improving facilities, and increasing the number of Native

American doctors. Factors such as poverty, geographic distribution,

language barriers, and lack of education create a need for more not less

money to achieve parity.

 

Congress has a moral obligation to not only honor treaties, fulfill trust

responsibilities, and provide quality health care but to carry out a law

explicitly intended to address health disparities.

 

History: IHCIA provides a detailed structure of how to deliver health care

to a scattered and unique group of people and how to remove barriers to

improvement of the system. Revising the act is a major task, so the Indian

Health Service convened a National Steering Committee in 1999 to work out

details about reauthorization. Tribes with widely different needs came to

an agreement on how to improve health services and the flexibility of the

health care delivery system. By all reports, the relevant agencies thought

this grassroots committee did a masterful job and all players have been

trying to get the act reauthorized ever since. Changes were made in 2002,

2003, and 2004 to take into account recommendations from the Secretary of

Health and Human Services and others in the Administration. S 556 was

introduced March 3, 2003, and HR 2440 was introduced June 11, 2003. A

joint hearing between the House and Senate was held a year ago. The fifth

oversight hearing on these!

proposed bills is scheduled for July 21.. Yet, the Administration has not

let S 556 and HR 2440 proceed even though these bills were initially drafted

by dozens of tribal attorneys in cooperation with congressional staffers at

the request of the Indian Health Service, a federal agency.

 

Current Political Situation: Unfortunately, the key bills to reauthorize

the act still have not been " marked up " or cleared. The White House has had

months to review S 556 and HR 2440 but has not released its reactions,

positive or negative. Such inaction is more than puzzling given the years

of hard work by the Indian community to involve all stakeholders and to

craft reasonable bills in both houses of Congress that meshed well with each

other. The inaction dismays advocates for Native Americans who created a

bi-partisan consensus, secured legislative and oversight hearings (such as a

joint hearing a year ago July), monitored numerous versions of these lengthy

technical bills, and had been assured that reauthorization was a high

priority for the heads of the key committees. The fact is that urban and

rural families in Alaska and the lower 48 states need quality health care

programs and funding to run those programs.

 

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FCNL Native American Legislative Updates are intended as a supplement to

other FCNL Native American Program materials and do not reflect FCNL's

complete policy position on any issue, nor do they include all pertinent

facts on any topic. For more information, or to request the FCNL Indian

Report and other background documents, please contact FCNL's Native American

Advocacy Program:

Friends Committee on National Legislation

245 2nd St. NE, Washington, DC 20002

email: Indian

Phone: (202) 547-6000

Toll Free: (800) 630-1330

Fax: (202) 547-6019

Web: www.fcnl.org