House subcommittee approves Indian health care bill

Thursday, November 8, 2007  

A House subcommittee approved the Indian Health Care Improvement Act on Wednesday but Senate action on the bill remains up in the air.

For the last three weeks, tribal advocates have been eagerly anticipating Senate consideration of the long-delayed measure. "That is our number one priority on the national front," Jackie Johnson, the executive director of the National Congress of American Indians, said recently.

Little, however, has happened since the Senate Indian Affairs Committee sent S.1200 to the floor on October 16. Meanwhile, the House is moving forward on its version of the bill.

The latest action came from the House Energy and Commerce Committee. The panel's Subcommittee on Health approved H.R. 1328 yesterday by a voice vote after making some changes.

"Reauthorizing the Indian Health Care Improvement Act ensures that Indian Health Services has the resources to respond to the complex needs of American Indian and Alaskan Native communities," said Rep. John D. Dingell (D-Michigan), the chairman of the committee.

The committee released a summary of the changes and a copy of the amendments yesterday. Just about every section of the bill, from Medicaid to facilities construction to scholarships saw some modifications.

"Native Americans do not receive a level of services comparable to other Americans," said Rep. Frank Pallone (D-New Jersey), the chairman of the Health subcommittee at the markup yesterday.

The bill could see more amendments if Republicans have their way. GOP lawmakers might seek to address urban Indian health care programs, which the Bush administration has questioned as unconstitutional.

Rep. Nathan Deal (R-Georgia), the top Republican of the subcommittee, said he supports reauthorization of the IHCIA. But he noted some "outstanding concerns" about the bill that he hopes to address before it goes before the full House Energy and Commerce Committee for a markup.

Deal cited cost-sharing, a negotiated rule-making provision, Medicaid licensing and U.S. citizenship requirements for Medicaid eligibility. The bill currently allows the use of tribal membership documents to receive Medicaid services, which Deal said were not sufficient.

Republican opposition has kept Congress from reauthorizing the IHCIA for seven years. Last fall, on the eve of consideration in the Senate, the Department of Justice released a "white paper" that outlined a number of objections to the bill.

The document kept the IHCIA from advancing in the 109th Congress. After Democrats won control of the House and Senate in the 110th Congress, they have vowed to pass the bill, though that promise has yet to be fulfilled.

H.R.1328 has already been approved by the House Natural Resources Committee. It is still being considered by the House Ways and Means Committee, in addition to the House Energy and Commerce Committee.

House Energy and Commerce Committee Documents:
Summary | Manager's Amendment | Press Release | Webcast

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

Relevant Documents:
Letter to President Bush | Letter to Alberto Gonzales | DOJ White Paper

Relevant Links:
Indian Health Service - http://www.ihs.gov
National Indian Health Board - http://www.nihb.org