Alton Villegas, a young citizen of the Salt River Pima-Maricopa Indian Community, smiles after presenting testimony at a Senate Committee on Indian Affairs hearing on diabetes on March 29, 2017. Photo: SCIA

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Congress approves yet another short-term extension for Indian diabetes program

Monday, October 9, 2017

Congress has renewed the Special Diabetes Program for Indians but only for three months, the shortest extension on record.

The program, which has contributed to a reduction in diabetes in Indian Country, was due to expire on September 30. It was saved, albeit on a very temporary basis, by a provision in H.R.3823, the Disaster Tax Relief and Airport and Airway Extension Act, which President Donald Trump signed into law barely a day before the deadline.

The provision, found in Section 301 of the measure, ensures that the IHS can distribute grants to tribes, Alaska Natives and urban Indians for the next three months. The program was funded with $37.5 million, which represents the usual level of funding.

But while the new law averts a temporary crisis, the National Indian Health Board pointed out that it expires on December 31. The organization has been lobbying for longer extensions in order to maintain Indian Country's successes in preventing and treating diabetes.

"SDPI supports treatment and prevention in American Indian and Alaska Native communities impacted by type 2 diabetes at a rate of 15.1 percent, prevalence higher than any other minority population in the United States," an October 2 letter to key members of Congress stated. "SDPI has resulted in a 54 percent reduction in kidney failure rates among Native American populations between 1996 and 2013."

American Indian (AI) and Alaska Native (AN) adults suffer from the highest rates of diabetes in the United States. Source: Centers for Disease Control and Prevention

According to the Centers for Disease Control and Prevention, 14.9 percent of Native men over the age of 18 have been diagnosed with diabetes, the highest among all racial and ethnic groups in the United States. And 15.3 percent of Native women suffer from the condition, again the highest rate in the nation.

Grants from the SDPI have kept the rates from growing even higher, according to tribal advocates and key lawmakers. Yet Congress has been reluctant to authorize long-term extensions or provide more funding for the program

As a result, tribes have had to settle for two-year and one-year extensions, instead of the five-year extensions that were common in the past. The three-month extension is the shortest so far.

There are efforts to attach SDPI to the Children's Health Insurance Plan, an otherwise popular program that expired at the end of September. A two-year extension has been included in H.R.3922, the Community Health And Medical Professionals Improve Our Nation Act, or the CHAMPION Act.

H.R.3922 was approved by the House Committee on Energy and Commerce at a markup on October 4. It authorizes $150 million in grants for each of the two years, or the same level of funding in the current program.

That same day, the Senate Finance Committee held a markup and approved S.1827, the Keep Kids' Insurance Dependable and Secure Act (KIDS Act), to reauthorize the Children's Health Insurance Plan. The bill does not include SDPI at this point.

Separately, Rep. Norma Torres (D-California), the top Democrat on the House Subcommittee on Indian, Insular and Alaska Native Affairs, has introduced H.R.2545 to renew SDPI for five years. Her bill would also increase funding levels in the coming years.

A newly-introduced bill, H.R.3917, reauthorizes the program for just two years. It maintains the $150 million funding level and takes into account the three-month extension that was just signed into law with H.R.3823.