Monday, March 11, 2013

Obama's Sequester Harms Indian Health Care

Indian Country Today has the details:

The many ways the federal government’s sequester will hurt Indian country are easy to see. The National Congress of American Indians has released a policy paper saying that tribal economic growth has already been thwarted; the National Indian Education Association has said the cuts “devastate” Indian education; and Native journalist Mark Trahant estimates that the overall financial reduction for funding in Indian country totals $386 million—and that’s just through the end of September.

In all, the joint decision by Congress and the Obama White House, first made in 2011 and carried out on March 1, to allow an across-the-board 9 percent cut to all non-exempt domestic federal programs (and a 13 percent cut for Defense accounts)—known collectively as the sequester—amounts to a major violation of the trust responsibility relationship the federal government is supposed to have with American Indians, as called for in historic treaties, the U.S. Constitution and contemporary American policy.

While all of the cutbacks are troubling and difficult to bear, perhaps the most problematic of all are the ones happening at the Indian Health Service (IHS), housed in the U.S. Department of Health and Human Services. The IHS must offer healthcare to enrolled tribal citizens, providing services for what are often the poorest of all Indians who live on reservations and can’t afford other healthcare.

With even the smallest of federal cuts, the agency—which has been vastly underfunded, by most tribal accounts, for decades—would have a more difficult time carrying out its mission. But it turns out that a sequester miscalculation—made through a combination of IHS error in misreading relevant law and a judgment call by the Office of Management and Budget (OMB)—has ended up costing tribal citizens much more than they were originally told.

IHS Director Yvette Roubideaux and her staffers had said at various tribal meetings and in letters throughout 2011 and early 2012 that “the worst-case scenario would be a 2 percent decrease from current funding levels” for IHS, rather than the 9 percent that was forecasted for most federal agencies if the sequester went into effect.

But Indian country began to learn late last year that Roubideaux’ predictions were wrong. IHS would be cut on March 1 at the same rate as every other non-protected agency. And since IHS was late to the game in planning for the larger cut, it didn’t work as aggressively at saving and protecting its resources as it could have. Also—and perhaps most egregiously—it fed tribes misinformation that cost them months of planning and advocacy time. “It’s unfortunate that we all relied on [IHS’s] earlier interpretation, because we could have addressed this earlier with the administration (especially the OMB) and the Congress,” said Jim Roberts, a policy analyst with the Northwest Portland Indian Health Board.


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