Story Published:
Mar 22, 2010
Story Updated:
Mar 23, 2010
WASHINGTON – Historic national health care legislation, which includes reauthorization of the Indian Health Care Improvement Act, has passed Congress and has received the president's signature.
In the late hours of Sunday, March 21, the House of Representatives voted to approve a sweeping health bill the Senate had passed just before Christmas. President Barack Obama signed it into law March 23.
The final vote was 219-212, with no Republicans voting in favor, and 34 Democrats voting against.
The bill is expected to provide health coverage to approximately 32 million Americans who currently do not have any. It aims to reform the health insurance system in a number of ways, including banning pre-existing condition exemptions, capping out-of-pocket expenses, increasing competition and providing increased government oversight.
Under the legislation, most Americans will be required to buy health insurance. Support for low-income citizens is part of the plan. Special provisions for Native Americans, given their special political status, are also expected.
Analysts said the legislation equates to the largest expansion of federal health care guarantees since Medicare and Medicaid were enacted in the 1960s.
The bill costs $940 billion, and the non-partisan Congressional Budget Office anticipates that it will cut the federal deficit by more than $1 trillion over the next two decades.
Every Democratic president since Harry Truman has pushed for universal health coverage. The legislation is widely seen as a significant step toward that goal, and is a major victory for Obama. He and Congress spent more than a year hashing out details of the plan, and more than once faced collapses in moving forward.
“This is what change looks like,” Obama said in a speech just before midnight. “It’s a victory for the American people, and it’s a victory for common sense.”
In terms of Indian health, the legislation permanently reauthorizes IHCIA, a law which provides an array of support to IHS and other programs that aid Native American health. It was first made law in 1976.
According to a statement from the National Indian Health Board, “the United States’ 564 federally recognized tribes claim victory with today’s historic passage of the Patient Protection and Affordable Care Act.”
Indian advocates have said throughout the lengthy time it took to pass the bill that permanent reauthorization was crucial, so they don’t have to ask Congress every few years to approve policies that a majority already agrees makes sense.
Congress has failed many times over the years to reauthorize the law in a timely manner, so its permanent reauthorization is seen by many Indian advocates as a major victory.
“This inclusion of the IHCIA reaffirms the government’s trust responsibility to provide health care to our people,” said Rachel Joseph, a citizen of the Lone Pine Paiute-Shoshone Tribe of California and co-chair of the National Steering Committee on the Reauthorization of the IHCIA.
According to the NIHB, the legislation’s influence on Indian country is multi-fold. Officials with the organization said it improves workforce development and recruitment of health professionals in Indian country; provides funds for facilities construction as well as maintenance and improvement funds to address priority facility needs; creates opportunities for access to and financing of necessary health care services for Indians; and assists with the modernization in the delivery of health services provided by IHS.
The White House said in the days leading up to passage of the legislation that it would “modernize the Indian health care system and improve health care for 1.9 million American Indians and Alaska Natives.”
Also passed by the House as part of the reform package was a list of compromises to the Senate bill, which is expected to vote on those changes in the coming days.
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Cali Pomo said on Thursday, Mar 25 at 3:50 PM
58 year old. Worked majority of my adult life disabled and still working. I recently quit a job I traveled 90 miles one way to work for my tribe, now a 20 minute drive. I have a 90 day wait period before I get insurance and then a 6 month wait for pre-existing conditions. My COBRA is over $500 with the New Health Care bill my COBRA will be a little over $300 per month. I should now be able to get an affordable insurance and not wait for the pre existing time. Also, I shall still have the local IHS medical facility
40022841NativeGI said on Wednesday, Mar 24 at 4:53 AM
this bill is just like social security. the young paying for the old... i predict like social security its gonna go belly up... the gov't can not do anything right, if you didn't like ihs care before and went else where for better care you won't be able to now... its ihs for the all of america.
39899626RedStar - Wampanoag Nation said on Tuesday, Mar 23 at 9:44 PM
We contiue to put or faith in the government instead of the Creator. What will it take for us to realize we all have to help each other. There are many state reconized tribes that should benefit from the funds that are allocated to our people.I pray for LEADERSHIP!! LEADERSHIP.Our children are elders and children are suffering. always is to stay true to ourselves.
39886889Candace Colbert Odom said on Tuesday, Mar 23 at 7:22 PM
I read the Reinstatement of the Indian Healthcare and there seems to be alot of things that were in the old IHS bill crossed out in the Reformed Bill? Were these things crossed out in the previous IHS Bill or did the reform package that the Obama Administration just pass cross-out all those things that were on the old Indian Health Care???
39880011Deaf Indian said on Tuesday, Mar 23 at 6:34 PM
Does this mean I can get new hearing aids now? I have been without hearing aid for 3 years because IHS told me they had no money to buy me hearing aids.
39877464ihs patient no. y said on Tuesday, Mar 23 at 3:09 PM
aside from the smog, i still haven't got my flu shot. this time i just refused. live dangerously. How much will the insurance premium pay for?
39850304x said on Tuesday, Mar 23 at 2:13 PM
"special political status" - what is that? what is the name?: wards? captives? prisoners?
39835716Da Renagade said on Tuesday, Mar 23 at 12:47 PM
Native Americans still have the highest infant mortality rate. Maybe this will improve with access to regular hospitals.
39828756Brandon said on Tuesday, Mar 23 at 12:32 PM
Michael O, it's not up in the air... and the answer to your question was in the first part of the article. I think this is a positive move for the nation as a whole and welcome more dialogue on it.
39827444Donte said on Tuesday, Mar 23 at 12:26 PM
This is bad very bad this health care bill will no different than native health care the goverment fails that everything it does american is the new Rez/getto.
39826859the big native said on Tuesday, Mar 23 at 12:17 PM
just remember who was responsible for sterilizing thousands of native women during the 60's and 70's. Now we are going to have to self identify ourselves as tribal members when we file taxes. Assuming the special provision is put in to make native americans exempt. This could be disastrous. By doing that we are already are ceding freedom. Tribal employers are also going to have to file taxes. Even if they won't pay any taxes they will be held accountable to the IRS.
39826104Jennie said on Tuesday, Mar 23 at 10:41 AM
Yay for change. Change always brings good and bad. Lets wait to see what the bill will deliver. We have suffered under the current IHS health care system. It's time for us to get quality care too. Maybe IHS can buy us all health insurance and we can go to quality doctors now.
39818211Nancy S. said on Tuesday, Mar 23 at 12:26 AM
Be careful! Obama took $'s from other places (Medicare, student loans, etc) to supposedly pay for this health care reform. IHS is already needy of overhauling, but could he take from us?
39796014John said on Tuesday, Mar 23 at 12:06 AM
Obama lied when he promised us a seat at the table on issues that concern us. We were a speck in the health care debate and on legislation that was written specifically to harm us like the PACT Act, a debate never even occurred. Washington continues the American tradition committing irreparable harm to Native people while still getting a handful of Native voices to sing the praises of the President.
39795127Crow Warrior said on Tuesday, Mar 23 at 12:05 AM
Obama had the Intestinal fortitude to finally address health care. Greedy health insurance crooks have had their way with us for too long! Instead of using his powere to enrich himself and his cronies like Bush did He's serious about helping the less fortunate of Americans!
39795116Concern NDN said on Monday, Mar 22 at 10:29 PM
Could the government be trusted??? When all is said and done, IHS and our insurance program may be an extension of Medicaid Insurance through direct merger. Good luck.
39790694Don Sanderson said on Monday, Mar 22 at 10:26 PM
I feel sorry that it appears all of America will now be under IHS type care, and that as usual we natives well fare even worse.
39790572HonorIndians said on Monday, Mar 22 at 9:53 PM
YAY!!! IHS quality health care for all. Thank you President Obama for the Reservationization of America.
39788836Cindy Tomesh said on Monday, Mar 22 at 9:51 PM
This is a step in the right direction for any of us natives that put our trust in President Obama to say last evening we met a large VICTORY with rights for health care to all no matter what race, religion, political status etc.
39788731Quinaultbob said on Monday, Mar 22 at 7:12 PM
My Treaty says health, education and Welfare as a Covenant, condition and Restriction (CCR) of the Quinault Treaty. The condition was in place because Gov Stevens did not want indians in White Hospitals! My aunt and uncle drove past 5 hospitals including the hospital my Aunt worked in as a CNA to warm Springs Oregon in the 1940's-1958. The quinault Treaty says fish in common with the citizens of WA that gavve us 50% ownership of the fish, shellfish and game of WA. We also have a ccr for health care as condition of our treaty. otherwise give us back out homeland! Robert Jackson (Quinault)
39780526Dave Monture said on Monday, Mar 22 at 6:21 PM
What about pooling Indian country health insurance into a national exchange to complement IHS services? Dave Monture, Kodiak AK
39777444Half & Half said on Monday, Mar 22 at 5:43 PM
I believe this is a step in the right direction. And it could not be at a better time, either. If executed correctly, Natives stand to have a choice and better health care. Let's see how it pans out.
39775106Corn Planter said on Monday, Mar 22 at 5:05 PM
Gifts in one hand, a club in the other. Caution on surrendering sovereign nations status and property rights for this health care bill. It appears a direct point of control by the corp known as USA, an issue for all Americans, Native or otherwise. Honorary Brother of the Corn Planters
39772119Reano said on Monday, Mar 22 at 4:57 PM
At last!!!!! Natives across U.S. have been denied services for extra care under the old IHS, hospitals shut down, clinics closed, less and less to almost depletion of healthcare for Native Americans. We have done without long enough.
39771594Meliss said on Monday, Mar 22 at 4:34 PM
@ here we go again; you'd rather rely on IHS that isnt nearly as quality care as it should and could be. I'd rather my parents have the option to buy low cost coverage than continue to rely on aspirin and penicillin from IHS. Yes indians may be excempt from this bill. Indians want to be sovereign yet this bill is passed and now there will be upset indians. But again IHS doesnt focus on quality, there's no funds to rate how well the IHS operate and how pleased are patients.
39769786Melinda B said on Monday, Mar 22 at 4:07 PM
I believe this is a step forward. We as Indian People need to step up to the plate and have our own insurance if we work. I do. You work, you pay. IHS should offer preventive medicine programs.
39767669Here we go again said on Monday, Mar 22 at 3:57 PM
This is a sham, the federal government does not have the authority to conduct itself in this manner. This violates the constitution, which we Indian People must support, because it is the constitution which gives us our special relationship. Besides this, I am from a treaty tribe, just try and force insurance on me.
39766836Michael O said on Monday, Mar 22 at 11:31 AM
Hard to say what this will do in the long run. Will natives who have relied on IHS be forced to buy health insurance? How soon will File Clerk have before they are fired now that funds are available to digitize charts? Right now it seems to be up in the air. And, only time will tell
39744594Shalishah - Yurok/Hupa said on Monday, Mar 22 at 11:29 AM
Thank you, Obama!!
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