Republican presidential candidate Jeb Bush tours the University of Tennessee on October 10, 2015. Photo from Facebook

Republican presidential candidate Jeb Bush outlined plans to repeal the Affordable Care Act on Tuesday, a move that would dismantle the Indian Health Care Improvement Act and leave Indian Country without a solid alternative.

Bush wants to "replace" the Affordable Care Act with a series of reforms that he believes would lower health care costs. But he did not say what he would do with the Indian Health Care Improvement Act if Congress tosses it out the window.

"If we’re going to fix health care in this country, we need to wrest control away from Washington and give it back to the states, citizens and their care providers," Bush said on his website.

Republicans in the House have repeatedly voted to repeal the Affordable Care Act. But like Bush they have never offered a clear path to reauthorize the Indian Health Care Improvement Act.

A clear path is needed because it took Congress more than a decade to renew the law. Republicans and the Bush administration placed a series of hurdles in front of Indian Country that were finally lifted when Democrats and President Barack Obama made the Affordable Care Act a reality in March 2010.

The historic law includes a permanent reauthorization of the Indian Health Care Improvement Act, preventing tribes from having to ask Congress every few years to pass a new version. A stand-alone bill would face significant delays if the Affordable Care Act were repealed.

The Indian Health Care Improvement Act gives tribes more flexibility to administer health care funds and authorizes new programs at the Indian Health Service for long-term care, youth suicide prevention and mental health treatment, among other provisions. It also prevents tribal and IHS benefits from being taxed by the Internal Revenue Service, an issue that was affecting tribes nationwide.

Not every provision has benefited Indian Country as some tribes are facing millions of dollars in penalties for failing to provide health coverage to their employees. Congress could always take action on that issue alone by exempting tribal enterprises from the large employer mandate.

The Tribal Employment and Jobs Protection Act (S.1771 | H.R.3080) would clarify that issue once and for all without repealing the Affordable Care Act or affecting the Indian Health Care Improvement Act.

Get the Story:
Bush offers plan to repeal, replace federal health care law (AP 10/13)
Jeb Bush Offers Health Plan That Would Undo Affordable Care Act (The New York Times 10/14)

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