health clinic

The front door of the Alabama-Coushatta tribe’s Chief Kina Health Clinic in Polk County, Texas.
Photo: room317

A bill reauthorizing funding for Native American health care is stalled in the U.S. Senate, stuck behind rancorous debate over a federal wire-tapping bill and threatened by a veto from President George W. Bush.

The bill authorizes spending for the Indian Health Service, which provides health care for 1.8 million American Indians and Alaskan natives. The legislation affects every aspect of Indian health care — from suicide prevention (suicide is the second leading cause of death among Indian young people), diabetes treatment (Indians are 2.6 times more likely to have this disease) and overall health (Indian life expectancy is six years less than for the US population as a whole). The bill pending in the Senate contains reform provisions for a health service that is routinely criticized in Indian country.

Monday morning, an editorial in the New York Times said Bush’s threatened veto ” is both cruel and grossly unfair.” Noting that the federal government spends only half as much per person on Indian health care as for health care for federal prisoners, the Times asked Congress to “rebuff” the president and pass the bill.

“For nearly a decade, Tribal leaders have been working to reauthorize the bill that serves as the underlying authority for the Federal government’s responsibility to provide health care to American Indians and Alaska Natives,” the National Congress of American Indians said in a statement. “We have worked on this bill for years. It has been negotiated, amended, revised, wordsmithed and compromised. It is now in the hands of Senate leadership and we want them to move the bill.”

The bill is now caught up in the partisan mess that is making progress on almost any issue in Congress nearly impossible. First, the Indian Health Services bill was placed ahead of the huge surveillance bill. The health services bill was expected to pass quickly — but then the Bush Administration threatened a veto, listing 18 “serious concerns.” For example, the president objected to provisions in the bill that would extend federal prevailing wage requirements to projects built with Indian Health Service funds. Bush also objected to the Urban Indian Health Program, which provided health services to Indians who live off reservations and in cities, according to the Argus Leader of South Dakota.

Faith Bremner at the Argus Leader explained that the federal government “has long provided free health care to Native Americans in exchange for native people giving up their claims to some 400 million acres of land. Most of the peace treaties that Congress signed with Native American nations promised to provide health care. Yet the federal government spends twice as much, per capita, on health care for federal prisoners as it does for Native Americans.”

Now the bill is backed up behind the surveillance bill, and that is causing consternation among Native Americans. Indian Country Today wrote today (Friday):

“Senate Minority Leader Mitch McConnell, R-Ky., argued that the bill wasn’t as important as the passage of the Foreign Intelligence Surveillance Act, an item higher on the Republican agenda. ‘American lives will not depend on the passage of Indian health care by the end of this month,’ he said during the Senate debate. There are millions of Indian people and their supporters who might beg to differ. Human rights and dignity are at issue here; it is unconscionable to delay this critical legislation any longer.”

indian doctor

A public health service doctor stuck in the mud on a reservation about 1910.

The stalling of the health services bill is also being pulled into the presidential campaign, a little more than a week before Super Tuesday primaries, when several states with large Native American populations will be voting. RedClout (journalist Kevin Abourezk) notes that the Republican candidates are “silent on Indian health bill.” Abourezk writes that none of the top Republican candidates responded to questions about the health care act.

All the Democratic candidates, Abourezk says, support the bill. Sen. Hillary Clinton is a co-sponsor.

(Abourezk writes about all the candidates in a story headlined “A Season of Neglect for Native People.”)

A vote on the surveillance bill is set for Monday. To keep up with the bill, go to the site of the National Indian Health Board.

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