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By Jenna Kunze
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Ten hours before the spending bill that funds the Indian Health Service expires, leaving more than 2.5 million Native Americans without access to health care, Congress has won a historic victory for Indian Country.
Thursday Dec. On February 22, the Senate passed President Joe Biden’s $1.7 trillion Omnibus Spending Bill that will fund the government for most of 2023. This bill includes a significant policy change for the country. Indian: $9.5 billion in advance credits available for the Indian Health Service (IHS) over the next two years. The House passed the bill around 2 p.m. EST on Dec. 1. 23, sending it to be signed by President Biden ahead of a government shutdown that would begin at midnight tonight.
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Advance appropriations signify a major shift from how the federal government has historically funded IHS, which is the only major federal health care program subject to annual appropriations.
These annual appropriations make the tribes vulnerable to budget uncertainties and government shutdowns. In December 2018, when the federal government shut down for a record 35 days, IHS was unable to fund tribal health care operations and as a result many tribal health care employees were fired and the tribal citizens were unable to obtain proper care. .
Advance credits are a budget solution that tribal leaders have been advocating for about a decade. They allow new funds to become available a year or more after the year of the appropriation act in which they are contained.
Leaders of the National Indian Health Board, National Council of Urban Indian Health and National Congress of American Indians celebrated the hard-fought victory Friday in a joint press release.
“The inclusion of Indian Health Advance Credits in the omnibus has been a historic moment for Indian Country for more than a decade,” said National Indian Health Council (NIHB) Chairman William Smith. (Indigenous Tribe of Valdez), in a statement. “While Indian healthcare remains chronically underfunded, this provision will help ensure that the Indian healthcare service can provide stable and uninterrupted care to our people, even in the face of a government shutdown. We are confident that we can build on this victory and continue our work towards full and mandatory funding of India’s health service, delivering on the promises this country made to our people more than two centuries ago.
Former NIHB Program Government Relations Director Aaron Payment (Chippewa Indian Tribe of Sault Ste.) called Congress’ passage of pre-approvals for IHS funding “a monumental first step.” in compliance with treaty obligations.
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“The funding the tribes receive is nominal compared to the valuation of the hundreds of millions of acres the tribes have ceded,” Payment told Native News Online. “Withholding our funding is an abrogation of the treaty and the obligation of confidence.”
Plus, Payment added, “the shredded pill is only good for the first year.” In subsequent years, Congress will allocate the funds as usual, as the IHS will already have been a year ahead.
“We think after the first year there will be no more problems,” Payment said. “Then we’ll move forward with credits for interior, and IBE, and any tribal funding under the EPA.” All of our funding should be earmarked in advance, and it should also be mandated. »
The decision also puts IHS on a par with other major federal health care programs such as the Veterans Association, Medicare and Medicaid. Department of Veterans Affairs health care programs have been funded through advance appropriations since 2010. Both Medicare and Medicaid receive mandatory funding.
US Senator Jeff Merkley (D-OR), told Native News Online that government shutdowns in 2018 and 2019 were the force that gave Congress the momentum to finally move forward with advance appropriations for IHS.
Merkeley proposed advance appropriations for the Indian Health Service in her Senate FY2022 Interior, Environment and Related Agencies Appropriation Bill.
“It became clear when I took over as head of the interior subcommittee that I wanted to say that it is not acceptable for our responsibilities to the US government to provide health care services to tribes,” Merkeley said. “It is not acceptable for this funding to expire. Quite frankly, we have a model for dealing with this problem, which is the Department of Veterans Affairs. We had a great example tool to use, we just had to convince everyone we had to use it.
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About the Author
Personal editor
Jenna Kunze is a staff reporter who covers Indian health, environment and breaking news for Native News Online. She is also the publication’s senior reporter on stories related to Indian boarding schools and repatriation. His bylines have appeared in The Arctic Sounder, High Country News, Indian Country Today, Tribal Business News, Smithsonian Magazine, Elle and Anchorage Daily News. Kunze is based in New York.
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