Health | Politics

House committees given extension on IHCIA

Monday, April 28, 2008

It took the Senate more than a year to pass the Indian Health Care Improvement Act and it looks like it will take the House even longer.

The law, first passed in 1976, expired in 2000. Since then, tribes have been working feverishly on a new version but opposition from the Bush administration has prevented passage.

One success finally came on February 26, when the Senate passed its version of the bill by an 83-10 vote. But tribal leaders who hoped the move would spur the House into action have been disappointed.

"The United States has a longstanding trust and treaty responsibility to provide adequate healthcare to our people and it's about time that Indian Country has its health care modernized," said National Congress of American Indians President Joe A. Garcia. "With the U.S. Senate's overwhelming support of the reauthorization of the IHCIA, Indian Country is surprised the bill is still lingering in Speaker [Nancy] Pelosi's House of Representatives."

It's hasn't been entirely slow-moving in the House. The House Natural Resources Committee only needed a few weeks to hold a hearing on the bill, mark it up and approve it. The committee's report was finalized earlier this month.

The same can't be said for two other committees, however. The House Energy and Commerce Committee has had the bill for more than a year but has yet to vote on its passage even though the Health subcommittee already completed work on it.

The House Ways and Means Committee is even further behind. The bill was referred to a subcommittee more than a year ago but no hearings have been held.

Garcia, who also serves as chairman of the Eight Northern Indian Pueblos Council in New Mexico, called the situation a "gridlock." And Indian Country will have to wait even longer for it to clear up, since Rep. Nancy Pelosi (D-California) gave the two committees an extension -- until June 6 -- to finish their work.

With the presidential election fast approaching, the holdup puts the bill in peril. Legislation that doesn't pass either the Senate or the House by the summer of an election year usually ends up on the chopping block.

"Nothing gets done," Jackie Johnson, the executive director of NCAI, told tribal leaders recently.

When Rep. Frank Pallone (D-New Jersey) spoke at NCAI's winter meeting in Washington, D.C., he was pressed to explain why the Energy and Commerce Committee hasn't taken action. Pallone is the chairman of the Health subcommittee, which held a hearing and favorably reported the bill.

Pallone said there are two main issues holding up passage. The first is the status of the Freedmen, who are the descendants of former African slaves, as citizens of the Cherokee Nation of Oklahoma.

The bill will now include a provision to ensure the Freedmen are restored to citizenship within the second-largest tribe in the U.S. The Senate's version did not address the controversy.

"We've gotten the Freedmen issue behind us now, probably not resolved in the way that the Cherokee Nation wanted," Pallone told tribal leaders.

The second issue is one over abortions at Indian Health Service facilities. The Senate included an amendment in its version of the bill, which some Indian advocates say goes far beyond current law.

At the time of NCAI's meeting in early March, Pallone said he hoped his committee would resolve the abortion issue and advance the bill by the end of the month. But on April 4, his committee was given the two-month extension by Pelosi.

Indian Health Care Improvement Act Amendments:
S.1200 | H.R.1328