Senate budget includes $1B boost for IHS

Friday, March 14, 2008  

With little fanfare, the Senate on Thursday voted to add $1 billion to the Indian Health Service budget.

After winning passage of the Indian Health Care Improvement Act, Sen. Byron Dorgan (D-North Dakota), the chairman of the Senate Indian Affairs Committee, told tribal leaders last week that he was going to propose the amendment. But he wasn't sure he was going to succeed.

"I've done this before and I've lost before but I'm not going to quit," Dorgan said at the National Congress of American Indians winter session in Washington, D.C.

The outlook changed pretty quickly in the past few days After just a few minutes of debate, the Senate voted 69 to 30 to approve the amendment, which shifts around money in the federal budget to pay for the IHS increase.

"We have both a trust responsibility and treaty responsibilities for the health care of American Indians," said Dorgan. "They are the first Americans.

"Let me tell you how we meet our responsibility. We also have a responsibility to provide health care for incarcerated Federal prisoners," he added. "We spend twice as much money for health care for our incarcerated prisoners as we do to meet our promise to American Indians for health care."

Sen. Judd Gregg (R-New Hampshire) spoke in opposition to the amendment. He praised Dorgan for making "an exceptional case" about the failures of IHS to meet the needs of American Indians and Alaska Natives.

But he tried to cast the issue in terms of a politically controversial idea. "So however people vote on this amendment, I think we should understand that this vote is a condemnation of the idea of nationalizing our health care system," he said.

In the end, the roll call broke down largely along party lines. Twenty-nine Republicans and one Democrat -- Thomas R. Carper of Delaware -- voted against the amendment.

But a large number of Republicans -- 18 of them -- joined 49 Democrats, plus two independents, in voting for the amendment. Included were Oklahoma Republicans James Inhofe and Tom Coburn, both of whom had voted against the IHCIA on February 26.

Coburn, a practicing physician, has tried in the past to add money to the IHS budget. But the Senate has rejected his proposals, mainly because they moved money around in the Interior Department's budget rather than the overall budget.

All three presidential candidates -- Republican John McCain of Arizona and Democrats Hillary Clinton of New York and Barack Obama of Illinois -- voted for the amendment. None of the candidates were present for the IHCIA vote.

Only one Senator wasn't present for the vote yesterday. That was Democrat Max Baucus of Montana, who used his position as chairman of the Senate Finance Committee to advance the IHCIA.

Yesterday's vote was welcomed by NCAI President Joe Garcia. "Improving health care for Native people is a moral obligation that must be dealt with now," he said.

"With the recent passage of the Indian Health Care Improvement Act reauthorization in the U.S. Senate and now this $1 billion amendment to the Senate budget resolution that would fund Indian Health Services, we are making substantial advances in working to improve the health and well being of Native people," Garcia added.

The IHS amendment was part of the Senate's version of the 2009 budget resolution, which was approved early this morning after a slew of votes. The House yesterday passed its version of the 2009 budget without the IHS amendment. The two versions will have to be reconciled before final resolution.

In his fiscal year 2009 budget, President Bush requested $4.3 billion for the IHS.