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Health | Opinion
Tim Johnson: Health reform law responds to tribal needs


The following is the opinion of Sen. Tim Johnson (D-South Dakota).

As a member of the Senate Indian Affairs Committee, I have worked tirelessly to help improve health care across South Dakota’s reservations. Unfortunately, that battle has often been an uphill fight. That’s why I’m so proud that the historic health reform legislation signed into law by President Obama does not forget the needs of Indian Country. Although this reform does not solve all the issues facing Indian Country, it makes important strides I have long fought for.

Over the years, I consistently cosponsored legislation to reauthorize the Indian Health Care Improvement Act to coordinate health care efforts on our reservations and help ensure the federal government is living up to its treaty and trust responsibilities. Congress included this bill as part of the health reform legislation, and it has now been permanently reauthorized. No longer will tribal members have to worry about politics in Washington holding up reauthorization of this important measure.

For too long, the health care situation in Indian Country has remained dire. In South Dakota, infant mortality rates on our reservations are higher than any place in the country. This is in addition to disproportionate rates of diabetes, cancer, suicide and substance use and abuse. With passage of health reform and the reauthorization of this bill, our tribal communities are finally given the tools they need to begin addressing these epidemics.

A lack of mental health services has made it difficult to fully tackle the challenges faced across our reservations. Health reform will make important progress in this area by directing the Indian Health Service to establish behavioral health, prevention, intervention, treatment and aftercare programs for Indians.

Whether our reservations stretch across many miles or are more close-knit, each has unfortunately faced hurdles in finding and keeping qualified health care professionals in their community. Through a mix of enhanced scholarship programs and innovative new demonstration programs, doctors and health professionals will be more aggressively recruited and retained to provide care in underserved communities.

In a rural state like ours, you often have to travel long distances to visit loved ones, including those in nursing homes and long-term care facilities. For tribal members with no long-term care in their community, that distance can often be even greater. That’s why I’m glad that reform also directs the Indian Health Service to develop ways to keep our elderly loved ones in their homes, whether through home health care or community-based measures, for as long as possible.

In addition to the health disparities and barriers to care, our health care infrastructure in Indian Country is in disrepair. This legislation will allow the Indian Health Service, the Department of Veterans Affairs and the Department of Defense to work together and pool federal resources to provide better health care options for their service populations. These joint efforts to provide care through shared medical facilities and services will streamline spending to ensure federal entities are making the best use of their funds.

The passage of this historic reform, including the permanent reauthorization of the Indian Health Care Improvement Act, does not mean the fight to improve health services on our reservations is over. We have much work ahead of us in reversing the tide of declining health rates, but we have taken a dramatic step forward in modernizing the health care delivery system for our first Americans. I am proud to have helped craft and pass a comprehensive health reform bill that gives the issues facing Indian Country the attention they deserve.

Indian Health Care Improvement Act:
S.1790 | H.R.2708

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