Will Republicans muster enough votes to repeal the health care bill?
A Michigan Republican said over the weekend that he sees
“significant” bipartisan support for repeal, possibly even enough votes
to override a presidential veto.
U.S. Rep. Fred Upton, R-Michigan, said on Fox News Sunday, “If we
pass this bill with a size-able vote, and I think that we will, it will put
enormous pressure on the Senate to do the same thing.”
An outright repeal, however, requires two-thirds majority in both the
House and the Senate. A hurdle that is about as close to impossible
as it gets in Washington, D.C.
That’s why the Republican strategy includes three other elements:
Investigate, repeal sections and refuse to limit the money needed to
implement the law.
“The so-called The so-called Patient Protection and Affordable Care Act (PPACA)
has been widely criticized by the American public, and for good
reason,” Upton wrote last month. “... Real oversight is needed, and
the Energy and Commerce Committee will work closely with other
committees of jurisdiction to reveal, repeal and replace this law.”
And to use Upton’s phrase, these “so-called” probes already know
what they will uncover. As Upton himself put it: “Our investigations
will demonstrate the need to repeal this law and replace it with
common sense reforms that lower costs and increase accessibility to
healthcare without increasing government.”
But this is where the story gets complicated. Too bad there’s not that
same passion for oversight when it comes to the historical
underfunding for Indian health programs. Or, in general, what will any
of these investigations say about American Indian and Alaska Native
health? Will there even be a question about the impact of “reveal,
repeal and replace” for Native American communities?
I doubt it.
Yet many Republicans -- often with districts with large numbers of
American Indian or Alaska Native voters -- say they don’t like and will
vote to repeal the health care reform law, but they do like the Indian
Health Care Improvement Act. New South Dakota Rep. Kristi Noem
said as much during her election campaign.
But that logic is flawed: if there is a repeal of the health care reform
bill, there also will be a repeal of the “permanent” status found in the
Indian Health Care Improvement Act. The two laws are one.
There is no way, politically at least, to repeal health care reform
except for the Indian health care provisions (or for that matter, other
popular measures, such as relief for the donut-hole in Medicare). This
is a simple way of pleasing folks back home that means nothing.
There is no exception; there is only a divide between those who
would work with this law, complicated as it is, and those that would
start over with nothing.
Beyond that stark rhetoric however is a practical question. Will the
new Republican majority support stable funding the Indian Health
Care Improvement Act? The law is only an authorization to spend
money -- it must be implemented by an appropriations from
This is where the seeds of tragedy are being planted. The
Republicans are creating a new powerful budget post, chaired by
Paul Ryan from Wisconsin. He will have the authority to set a ceiling
for federal spending. The spending committees, then, would have to
spend below that ceiling. Some Republicans in Congress have
promised to roll back that spending as much as 20 percent. Imagine
the impact on an already starved Indian health system. (Ryan has
also called for abolishing Medicare for those under 55 years old as
well as the Children’s Health Insurance Program and Medicaid. All
three are key elements of funding the Indian health system.)
Republicans promised a frugal government. If that’s really what they
want, then the Indian health system should be fully funded because
it’s the most efficient health care delivery system in the country.
But that would require an exception to flawed logic.
Mark Trahant is a writer, speaker and Twitter poet. He is a member of the
Shoshone-Bannock Tribes and lives in Fort Hall, Idaho. Trahant’s new book, “The Last Great Battle of the
Indian Wars,” is the story of Sen. Henry Jackson and Forrest Gerard.
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