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White House blocked testimony on trust responsibility

Opening Statements

Panel 1

Q&A | Q&A

The White House changed the Senate testimony of Bush administration nominee Charles Grim to eliminate references to two federal laws that provide the basis for Indian health care.

Grim, the director of the Indian Health Service, told the Senate Indian Affairs Committee on Thursday that he didn't know why the language was removed from his testimony. "Sometimes, changes are made," he said, describing a review process that includes the White House Office of Management and Budget.

But the revision raised alarms from Sen. Byron Dorgan (D-North Dakota), the chairman of the committee. He tied it to the Bush administration's failure to back the Indian Health Care Improvement Act, one of the laws that was removed by the White House.

"You have previously indicated to this committee that you believe there is a trust responsibility rooted in law for the health care for Native Americans," he told Grim. "Is there a disagreement on that in the administration?

Grim denied any sort of "misunderstanding" that the IHCIA and the Snyder Act of 1921 form the basis for the federal government's responsibility to provide health care. At the same time, he could not explain why references to those two laws were removed.

"It was not communicated to me the exact rationale for that," Grim testified.

Just a few months ago, in fact, Grim and another colleague from the Department of Health and Human Services submitted testimony to the committee that cited the laws. "Two major statutes are at the core of the federal government's responsibility for meeting the health needs of American Indians/Alaska Natives," the statement from March said.

In prior appearances before the panel, Grim included nearly identical language about the IHCIA and the Snyder Act. At the hearing yesterday, he said he stood by those statements.

But with the White House holding up reauthorization of the IHCIA, those assurances weren't enough for members of the committee. Sen. Lisa Murkowski (R-Alaska), the new vice chair, urged Grim to do more to ensure the bill gets passed this year.

"It's been sitting around for 10 years-plus," Murkowski said. "It's well past time to get this to the president for his signature."

The change in the testimony, however minimal, speaks to a much larger policy shift within the administration. Officials have been slowly trying to limit who can and cannot receive federal health care benefits.

Although the two federal laws, along with treaties, have long been cited as the basis for Indian health care, the administration argues that services must be tied to membership in a recognized tribe and residence on a reservation. That affects the overwhelming majority of American Indians and Alaska Natives who don't live on reservations.

The Department of Justice says health care programs for urban Indians, lineal descendants and certain Alaska Natives could be struck down by the courts as unconstitutional because they are based on race. However, that has never happened in the history of the Indian health care system.

"Under the Supreme Court's decisions, there is a substantial likelihood that legislation providing special benefits to individuals of Indian or Alaska Native descent based on something other than membership or equivalent affiliation with a federally recognized tribe would be regarded by the courts as a racial classification," a deputy assistant attorney general told the committee back in March.

The revision to Grim's testimony isn't the first time the White House has intervened on a trust issue either. In July 2002, White House aides tried to prevent then-Special Trustee Tom Slonaker from telling the committee that the Bush administration's accounting plan was inadequate.

Slonaker went ahead and gave the testimony but was told to resign or be fired a few days later. One of the White House aides who was involved -- Kyle Sampson -- later went to work for the Department of Justice but resigned amid the scandal over the firings of several U.S. Attorneys.

Grim, a member of the Cherokee Nation, was before the committee to seek confirmation for a second term as director of the IHS. Dorgan, Murkowski and other members said they would support his nomination.

The following language was removed from Grim's testimony:
Two major statutes are at the core of the Federal government's responsibility for meeting the health needs of American Indians/Alaska Natives: The Snyder Act of 1921, P.L.67 85, and the Indian Health Care Improvement Act (IHCIA), P.L. 94 437, as amended. The Snyder Act authorized regular appropriations for "the relief of distress and conservation of health" of American Indians/Alaska Natives. The IHCIA was enacted "to implement the Federal responsibility for the care and education of the Indian people by improving the services and facilities of Federal Indian health programs and encouraging maximum participation of Indians in such programs."

Hearing Webcast/Testimony:
HEARING on the nomination of Charles W. Grim to be Director of the Indian Health Service (July 26, 2007)

Relevant Links:
Indian Health Service -
Senate Indian Affairs Committee -