WASHINGTON – Amid growing questions from citizens and Congress regarding his plans for comprehensive national health care reform, President Obama held a primetime press conference July 22 to address the issue.

While a specific plan has yet to be hammered out by lawmakers, Obama favors options that would impose a surcharge on the very rich to cover costs of providing government-supported health care to uninsured Americans. He has indicated that a plan in the House of Representatives that would tax families who make more than $1 million is in line with his expectations.

Obama has promised to veto any plan that would tax the middle class or poor.

Indian health officials have been largely supportive of the president’s agenda, since many Native Americans living on reservations and in urban areas don’t have health insurance, and tend to live under high poverty conditions.

Health experts familiar with Indian country also note that IHS programs have been perennially underfunded by Congress, making them unable to provide sufficient health offerings to many Native Americans.

As noted in several hearings of the Senate Committee on Indians Affairs, IHS contract funds tend to run out early in the year, leaving many Natives with few or no health care options.

One of the president’s overriding themes during the press conference was that reforming the system would be positive for all Americans.

“This is not just about 47 million Americans who have no health insurance,” the president said. “Reform is about every American who has ever feared that they may lose their coverage.”

He also believes that injecting competition via a government-sponsored insurance plan would dissuade private insurers from passing on health costs to their subscribers, thus reducing out-of-pocket costs for many Americans.

“Part of the reason we want to have a public option is just to help keep the insurance companies honest,” he said.

Changing the health care system is at the top of Obama’s domestic agenda, but polls have shown him losing ground on the issue, as some question whether he’s trying to do too much, too fast.

The latest Associated Press poll found the number of Americans who disapprove of the president’s health care plan has risen to 43 percent, compared with 28 percent in April.

Mark Trahant, a health-focused Native journalist who was recently selected as a Kaiser media fellow, has some skepticism, saying he believes Obama must address Indian health as part of his reform agenda – something the president did not do during the press conference.

“To me, it’s a matter of trust,” said Trahant, a member of the Shoshone-Bannock Tribe and the former editorial page editor of the Seattle Post-Intelligencer.

“If the U.S. can’t get this one segment of health care right [IHS programs] – one where there’s a direct service – then how are we supposed to trust the U.S. to reshape the entire system? The answer starts with more money for IHS, but it also requires inclusion in the broader conversation.”

Congress members, including Democrats and Republicans, have expressed a desire to have more time to work out the details of such complicated legislation. But Obama wants both the House and Senate to come to reconciliation and vote on the issue by early August.

One of the biggest causes for concern surrounds the cost of change – estimated at $1 trillion – especially considering the administration’s spending thus far on the stimulus package and the nation’s already steep deficit.

Obama addressed that question head on, saying that inaction would end up doing more harm to the economy, while continuing to increase the federal deficit. Nationwide health care costs currently account for 17.6 percent of the gross domestic product and continue to increase.