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Tribes push for reauthorization of health care act

Congress returned to session on Tuesday after a month-long break as tribal advocates geared up for a major push on the Indian Health Care Improvement Act.

After the law expired in 2000, lawmakers of both parties have tried to reauthorize it. But they have been met with opposition from the Bush administration, whose officials are challenging major and minor details of the proposal.

With Democrats in control of the House and Senate, the efforts have gained steam but the bill still has several hurdles to clear. Although the Senate Indian Affairs Committee and the House Natural Resources Committee have approved their versions, other key committees have yet to weigh in.

Tribal advocates hope the situation changes this month. The Senate Finance Committee has scheduled a markup on September 12, which means the bill can go to the Senate floor for a vote.

The markup takes place on the same day as a rally in Washington, D.C. The National Indian Health Board, the National Council of Urban Indian Health and the National Congress of American Indians hope to draw attention to the critical health care needs on reservations across the country.

"This is definitely the biggest push," Geoffrey Roth, the executive director of the National Council of Urban Indian Health, said on Native America Calling yesterday. "We are working as hard as we can to make sure the Hill understands this is the number one legislative priority for Indian Country right now."

Sen. Byron Dorgan (D-North Dakota), the chairman of the Senate Indian Affairs Committee, tried to advance the Indian Health Care Improvement Act before Congress went on break. He wanted to insert it into a children's health bill that passed the Senate in early August.

"There are 3 million children benefited by the children's health insurance bill, but there are 2 million American Indians who are subject to full-scale health care rationing," Dorgan said on the floor on August 2. "It is unbelievable what is happening."

But Dorgan agreed to hold off after Sen. Harry Reid (D-Nevada), the majority leader, promised a markup by the Senate Finance Committee, which is chaired by Sen. Max Baucus (D-Montana). Baucus sponsored the children's health bill that passed the Senate.

"So I support my friend from North Dakota and will do everything I can to move this forward and make a commitment that we will do something this session of Congress," Reid said in response to Dorgan.

Tribal leaders met with Democratic leaders in July to push for reauthorization of the measure. They have criticized the Bush administration and Republicans in the Senate for holding up passage.

"In 1999, a tribal leader and friend wondered if he would see the reauthorization of the IHCIA before he passed on," said Rachel Joseph, the chair of the national steering committee on the reauthorization of the bill. "He died in April of this year."

The bill was close to Senate passage before the November 2006 elections until the Department of Justice released a "white paper" outlining numerous constitutional and legal objections to health care for urban Indians, lineal descendants and certain Alaska Natives. Senate Republicans immediately put a block on the bill based on those concerns.

Bush officials, however, could not explain why or how the document surfaced. "I was told that no one in the Department of Justice released it," a top DOJ official told Dorgan in March.

Even in the bill moves forward in the Senate, it still has to clear the House Energy and Commerce Committee and the House Ways and Means Committee. Neither panel has taken action on the bill since March.

The September 12 rally will be held at 1:30 PM in the Lyndon B. Johnson Room of the US Capitol Building.

Indian Health Care Improvement Act Amendments:
H.R.1328 | S.1200

Relevant Documents:
Letter to President Bush | Letter to Alberto Gonzales | DOJ White Paper

Relevant Links:
Indian Health Service -
National Indian Health Board -