Health | Opinion

NIHB Chair: Tribal membership not for sale

Friday, August 24, 2007

The following was submitted by Sally Smith, the chair of the National Indian Health Board, to The Washington Times, which ran an Associated Press article about the sale of "tribal membership" to illegal aliens.

As Chairman and on behalf of the National Indian Health Board (NIHB), I am responding to an article (August 18 – “2 Tribes Selling Entry to Aliens”) regarding the Kaweah Indian Nation of Kansas and Pembina Nation Little Shell of North Dakota, two tribal entities not currently recognized by the Federal government as Indian Tribes, offering tribal membership to illegal aliens. Established in 1972, the NIHB serves all Federally Recognized American Indian and Alaska Native (AI/AN) Tribal governments by advocating for the improvement of health care delivery to AI/ANs, as well as upholding the Federal government’s trust responsibility to AI/AN Tribal governments.

Tribal membership in a Federally-recognized Tribe confers unique Tribal status that is not for sale. We were deeply disappointed and troubled to learn that some tribal groups think that tribal membership can be sold for a price. Members of Federally-recognized Tribes have already paid a huge price to be part of America: in exchange for over 400 million of acres of land, the Federal Government promised to provide benefits to Indian such as education, housing and health care. Despite these promises and treaties, American Indians and Alaskan Natives suffer disproportionately high health disparities compared to every other racial group in the U.S. population: For example, the infant mortality rate is 150% greater for Indians than that of Caucasian infants; Indians are 2.6 times more likely to be diagnosed with diabetes; Life expectancy for Indians is nearly 6 years less than the rest of the U.S. population; Suicide for Indians is 2 1/2 times higher than the national average – and even higher among our young people; and healthcare expenditures for Indians are less than half of what America spends on health care for federal prisoners. These issues are worthy of discussion and attention and it is outrageous and deeply unfortunate that the actions of these two groups calls attention away from these life and death issues facing the members of the 561 Tribes that are recognized by the Federal government.

In 2006, the NIHB, along with over 35 Tribes or Tribal organizations, commented on interim proposed regulations published by the Centers for Medicare & Medicaid Services (CMS) implementing the provision of the Deficit Reduction Act that requires States to obtain satisfactory documentary evidence of an applicant’s citizenship. In the NIHB comments to CMS, I wrote that “ Tribal governments find it rather ironic that Native Americans, in the true sense of the word, must prove their U.S. citizenship through documentation other than through their Tribal documentation. This same Tribal documentation is currently recognized by Federal agencies to confer Federal benefits by virtue of American Indian and Alaska Native (AI/AN) Tribal governments’ unique and special relationship with the U.S. dating back to, and in some circumstances prior to, the U.S. Constitution.” In 1924, in recognition of the number of American Indian men who served in World War I, Congress enacted the Indian Citizenship Act and conferred U.S. Citizenship to American Indians. Tribal membership in Federally-recognized Tribes can be traced back through genealogy charts dating back to original Tribal membership rolls, or as established by Treaty or Federal statutes, established prior to 1924. Nevertheless, on July 13, 2007, the CMS published final regulations implementing the Medicaid citizenship documentation requirements and much to the Tribes’ dismay, Tribal enrollment cards, except in a few instances, are not recognized as legitimate documentation of U.S. citizenship for Medicaid purposes.

Actions by tribal groups, such as the Kaweah Indian Nation and Pembina Little Shell, of “selling” tribal membership undermines legitimate Tribal sovereignty and the contributions of First Citizens of our great Nation. This debacle also draws critical attention away from legitimate issues on which Indian Country and the Nation al Indian Health Board are tirelessly working. Central to these issues is the reauthorization of the Indian Health Care Improvement Act - passage of which is critical to the health care of everyone in Indian Country.

We condemn the unfortunate actions of these two organizations and urge the Washington Times and its readers to recognize that such actions only harm the legitimate work of the Tribes and Tribal organizations to improve the plight of this Country’s Native Peoples."