Mark Trahant: Guaranteed rights to health care

Health | Opinion

Monday, October 19, 2009

"The idea that American Indians should be exempted from any mandate to purchase health insurance has almost become a given in the debate about health care reform.

Last week Speaker of the House Nancy Pelosi wrote to the National Congress of American Indians and said: “We cannot ask Indian people to be penalized for choosing to use the Indian health care system. The House bill will ensure that the exemption from the financial penalties is extended to federally recognized tribes and that tribally provided health care benefits are appropriately protected.”

The Senate Finance bill already contains such a provision.

I’ve wondered about this mandate from the beginning of the process. I know too many people who do not participate in the mainstream economy; many of these folks are either unable or unwilling to navigate such a complex system. Imagine someone who hunts, fishes or is involved in a subsistence enterprise, figuring out what part of their income should be used to purchase even subsidized health insurance.

But even if you agree with the exemption – as I do – there remains another issue to resolve, the money. Unless health care reform substantially improves the funding stream for the Indian health care delivery system, then the individual exemption is only a guarantee of permanent disparity. The reason for the exemption in the first place is the Indian health care system does not qualify as an acceptable insurance plan. The funding gap is too great."

Get the Story:
Full funding for a right ‘guaranteed’ by treaty (Mark Trahant 10/19)

Also Today:
Pelosi’s promise on health care reform and Indians (Indian Country Today 10/19)