Story Published:
Sep 18, 2009
Story Updated:
Sep 21, 2009
WASHINGTON – The nation’s top health official has told Indian country health leaders that the Obama administration believes American Indians deserve special consideration in any national reform to health insurance.
Speaking on Capitol Hill before an audience of Indian health leaders Sept. 15, Secretary of Health and Human Services Kathleen Sebelius reported that President Barack Obama said in an appearance before a joint session of Congress Sept. 9 that he supports a mandate that individuals must purchase health insurance, much like car insurance.
Such a mandate would require Americans to purchase health insurance with some degree of government assistance, depending on need and income.
But Sebelius said clarification was needed for Indian country, which traditionally has high amounts of uninsured, as well as a special relationship with the U.S. government.
“I’m going to make it very clear. ... this is what was left out on Wednesday night: The administration strongly believes that the individual mandate and the subsequent penalties don’t apply to American Indians or Alaska Natives.
“You have already purchased health insurance, it is already part of the agreement we made.”
Sebelius’ words met with loud applause from the hundreds of Native leaders who gathered in the nation’s capitol for a meeting of the National Indian Health Board advocacy organization.
IHS Director Yvette Roubideaux, a citizen of the Rosebud Sioux Tribe, said Sebelius’ statement was especially noteworthy, since the Obama administration hasn’t laid out many specific health policies; nor has it made many specific policy commitments to American Indians and Alaska Natives.
Mark Trahant, a Kaiser Media Fellow who is examining IHS and its relevance to the national health reform debate, said Sebelius’ promise was important, but he noted that she went farther than both of the current prevailing health reform bills in the Senate and the House.
“The Senate is supposed to exempt individual American Indians and Alaskan Natives from penalties, not the insurance requirement,” said Trahant, a citizen of Idaho’s Shoshone-Bannock Tribes. “The House bill does nothing in this regard.”
Even if final legislation doesn’t include provisions that exempt Indians, Trahant said the administration could still make good on Sebelius’ promise via added regulations.
Trahant also noted that IHS coverage, which meets some of the health needs of some Natives, would not qualify under the bills as acceptable insurance coverage, since it’s not an insurance program.
While questions still linger over how health care reform will impact Natives, some tribes, including those of the United Tribes of North Dakota board, have endorsed Obama’s reform plans. The group is made up of all five federally recognized tribes in the state, including the Three Affiliated Tribes, Spirit Lake Tribe, Standing Rock Sioux Tribe, Sisseton-Wahpeton Oyate, and the Turtle Mountain Band of Chippewa Indians.
In a resolution passed Sept. 10, the board said it didn’t believe the president’s plans would hurt IHS. Members also believe the president will assist Native Americans who do not have access to health care through IHS.
Beyond the health care reform mandate commitment, Sebelius pointed to the Obama administration’s increased funding to IHS as a sign of its commitment to improving health in Indian country. A 13 percent increase in funding for the agency was included in the 2010 budget, the largest amount given in two decades.
“This is long overdue and well-deserved,” Sebelius said.
The health secretary also affirmed the need for a strong government-to-government relationship with tribes, as well as tribal consultation. As an illustration of that promise, she noted that Roubideaux had consulted with several Indian leaders at a town hall meeting in Washington Sept. 14.
Sebelius also said she is committed to assisting tribal governments cope with the H1N1 virus – believed to be especially dangerous in communities with high incidents of diabetes, which is true in much of Indian country.
After Sebelius’ speech, NIHB Chairman Reno Franklin, a citizen of the Kashia Pomo Tribe, told the audience that the 13 percent increase to IHS was quite impressive.
NIHB board member Cathy Abramson, a councilwoman of the Sault Ste. Marie Tribe of Chippewa Indians, was pleased to hear Sebelius repeatedly state the treaty obligations of the federal government to tribes.
“President Obama is determined to make change in health care reform, and I believe he will do so, while making sure he honors our treaty rights,” Abramson said.
Beyond Sebelius’ speech, several members of Congress at the NIHB conference stated their support for improving Indian country health.
In an especially well-received talk, Sen. Lisa Murkowski, R-Alaska, highlighted her understanding of federal trust responsibility.
“Let us never forget that the first people paid in advance through the loss of lands, uprooting of people and culture, and enduring a multitude of ill conceived federal policy towards America’s first people that our Congress has been called upon to apologize for,” the member of the Senate Indian Affairs Committee said.
Later, when discussing the Indian Health Care Improvement Act, Murkowski acknowledged tribes have been waiting and working for 20 years to have it passed, saying, “it’s about time for a signing ceremony at the White House.
“First people first! We can’t reform health systems without fulfilling the commitment to improving the health care of the first people.”
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FRANK MULLENBERG said on Thursday, Dec 17 at 11:15 PM
YOU CANT GET ANYTHING GOOD GOING TO IHS I WENT FOR 3 YRS IN CROW AGENCY COMPLAINING ABOUT PAIN IN MY LEFT SIDE AND LOWER ABDOMEN FINALLY ONE NEW DOCTOR SAID IM GOING TO HAVE YOU GET A CAT SCAN. SUPRISED OH YA YOUR DIE FROM CANCER BECAUSE NOBODY BEFORE ME DID WHAT I DID AND SENT YOU TO GET A CAT SCAN AND IF YOU DIDNT HAVE INSURANCE I WOULDNT HAVE BEEN ABLE TO SEND YOU. BECAUSE OF A BLESED BUDGET CUT
33885792straight up native! said on Sunday, Oct 11 at 2:36 PM
What about tribes who under 638? No more IHS! In Navajo Country, eventually everyone will need insurance to go to the hospital.
30432558Living in the City said on Wednesday, Oct 7 at 5:49 PM
I agree with "Broke in AZ". If you live 180 miles from your IHS Service Unit you don't receive IHS. Yet, you are still used as a head count for $$'s your unit receives. IHS only benefits those living on the Rez. The rest of us have to buy insurance, or beg for Medicaid. IHS may not be the greatest, but it's better than some of us enrolled tribal members receive away from the Rez.I don't forsee any changes for Natives & IHS! Receive the same bad service! I know, I worked for IHS.
30266302WAMP1MASHPEE said on Wednesday, Oct 7 at 10:08 AM
LETS LOOK AT THE BIG PICTURE READ WHAT EVERY ONE SAYS THAT LADY WITH THE KIDS TAKE CARE OF YOUR SELF OR GO TO YOUR GOVERMENT AND FIGHT AS WE HAVE FOR THE PENNY WE GET NO DOUBT YOU WILL GET A DOLLAR OR GO BACK ON THE BOAT OR DID YOU HAVE CHILDREN TO GET THE "FREE" HEALTH CARE AND WHAT EVER ELSE YOU CAN GET WATCH WHAT YOU WISH FOR IT MAY NOT BE THERE TOMMORROW
30242922Walkinbeauty said on Tuesday, Sep 29 at 12:47 PM
After all the comments made about Health Care Reform, I am so confused. But, atleast we should be so glad we are getting increase and to use it wisely on health care. We all need to unite as a whole nation and fight no more, maybe than our whole nation will be at peace. I pray and long for that so much as I am getting older in years and thinking of my grandchildrens future. Keep strong everyone and live in peace and harmony in your hearts.
29848024Krissypoo said on Friday, Sep 25 at 9:52 PM
I can't believe there are other people out there claiming they've got it bad because of the color of their skin. I've never seen a more dislocated and struck down Nation that the Indian Nation. I've never seen a people more ignored and pushed around by the Federal Government. I pray the Indian Nation is blessed and receives double of what they have lost. I pray they become a strong and indestructible Nation. My fight and prayers are with all the Native Americans.
29689679Bobbie said on Friday, Sep 25 at 9:07 PM
Am I not important?I went threw the pain of having them and I wear a scar on my body.Doesn't that count for something?
29688334Bobbie said on Friday, Sep 25 at 9:05 PM
I have three Native children, their natural father has 6, that I know of.I am white and I have taken care of my boys from conception. They have Healthwave from the state of Kansas, I have none. I am their only parent that will take care of then. Heaven for bid something happen to me, they'd have to dig a whole in someones back yards
29688264ToAnonymous-YouIdiot said on Friday, Sep 25 at 7:45 PM
Color does matter. Im sure youve had enjoyed the joys of being white
29685569Anonymous said on Friday, Sep 25 at 5:34 PM
I do not mean to sound agains the reform but don't you think that we need to address some of the uninshured before we worry about people who have IHS. I am the white mother of an Indian son who has a family and needs heath care too. When you call your HMO and you can not go to the doctor because adults do not get ear infections and have to pay out of your pocket because you are in so much pain I think that there needs to be reform for all of us and it should not matter what color ones skin is.
29679534Shell said on Thursday, Sep 24 at 10:43 AM
This is a joke, there are those that don't have insurance that need IHS in an emergency, then there are individuals that abuse IHS and run to the doctor everytime there is a sniffle in the family, then there are us that have insurance use IHS as a secondary in the event of an emergency and are unable to pay for the decutable and the local IHS payee hold the check to the facilities because they have no money left in the account. So then you get collection letters and have to pay the balance.
29594537Broke in AZ said on Wednesday, Sep 23 at 7:59 PM
We live away from our home reservation and the IHS here wont give us all the benifits because we are not enrolled in the local tribe so they give them more money to help their people and I will still have to stuggle to pay for my own insurance? Let me know when the people who are slipping through the cracks will be taken care of.
29567717Bobbert said on Wednesday, Sep 23 at 10:17 AM
I have been around a lonnnnnnnnnnnnnng time; and have been blessed with this lingo many times before. Address the unmet need and I'll open my ears again to listen. Every administration professes their loyalty to NA/AN's. That is good! But they profess to an inadaquate health care system such as IHS. Cut out the expensive middle man-system; fund Tribes directly and fulfill the treaty and executiove order (s) commitment (s). We spend far to much on a system that has never done that well.
29537493Wesley R Smith said on Wednesday, Sep 23 at 2:47 AM
yes it seems that we are getting some good news for now but how long will he be able to stick to his words and what is the catch?We need to be able to use our tribal cards for services if we ever need medical assistance when we are not at home on the reservation. this would help out for us college students.
29525974Yvette said on Tuesday, Sep 22 at 9:53 AM
Lastly, so President Obama increased the budget for IHS by 13 million. That's wonderful. Now all we have to worry about is that the money is spent on health care needs, and not blown on top heavy Administration. I hope Tribal leaders across the Nation will speak out on these issues. I think it's important to not squander most of the 13 mil on adminstrative expenses.
29488083Yvette said on Tuesday, Sep 22 at 9:50 AM
Whoa. We most certainly still need IHS services. IHS varies greatly depending on where the facility is located. I've been wondering how the health care reform would address Native Americans. So, this Kaiser Fellow, Trahant says the Senate is suppose to exempt Natives from the penalties, but not from the requirement to purchase insurance. That statement was in future tense. When is this suppose to happen? How can we be guaranteed that the Senate will exempt Native Americans?
29487879Ecohokte said on Tuesday, Sep 22 at 3:02 AM
Again, President Obama is making "pie in the sky" promises he can't keep. I don't care how enthralled this Congress is with the ONE, they still won't approve exempting Indians from mandatory insurance. Their constituents are already threatening to vote them out. They won't care anymore today about honoring treaty obligations than their predecesors did. I pray our national native leaders won't be fooled by these empty words.
29479807Quinaultbob said on Tuesday, Sep 22 at 1:11 AM
The Quinault Nation Treaty has a CC&R (Covenant, Condition and Restriction that says HEW ... (Health, Education and welfare). Just as the US v. Washingon case established 50% ownership of the Salmon, shellfish and game The QIN HEW applies to all tribal members not just the 40% who live on the REZ. Did DSHS say all Indians or only Rez Indians. If so give us back 60% of our land of our usual and accustomed area i. E our homeland of 1850. Robert Jackson Quinault.
29478411Tammy D. said on Monday, Sep 21 at 6:07 PM
The federal IHS/CHS program now requires eligible Indians to apply to County social service agencies for payment of services at non IHS facilities. Since when is it the county's responsibility and not the Federal Govt? I'm embarrassed at having to apply for County Assistance when the Federal IHS/CHS should be paying for my medical care.
29465149question man said on Monday, Sep 21 at 12:38 PM
i sent an email director to dhhs director's office about what the life expectancy of indians was and so far i got no answer. and this was at least two months ago! let us this as inductive thinking; this should hint that what is 'promised' is, well, don't hold your breath. the cost of indian health care is nowhere near the value of socalled exchange for lands, etc. if real money equal to current marketvalue for land was made, we wouldn't need casinos.
29448182Tell the Truth & Shame the Devil said on Monday, Sep 21 at 12:36 PM
Oh brother - give me a break! It's just another group of U.S. politicians easing their "guilt"! The improvements will be minuscule because we have the same old IHS dinosaurs giving us the same old lip service that been doled out since the jump! Throwing good money after bad will NOT address or resolve this health care issues that plague Skins in Indian country. IHS works on the mentality of treatment care rather than preventive care! Essentially, the campaign of genocide continues.
29448029Ojibwe Health for our Future! said on Sunday, Sep 20 at 8:37 PM
Secretary Sebelius and Senator Murkowski said it all. Healthcare is a right that we traded our land, our water/mineral/oil rights for. Our Indian Health Service should be funded alongside other publicly funded clinics and health systems so that ALL Anishenabegg/Original People have.
29419562David Q said on Sunday, Sep 20 at 2:22 PM
This is in response o Phil Savilla: Yes the IHS is underfunded, but without IHS, even with the proposed health care reform measures, the Health Care of Native Americans would drastically and negatively impacted. Also Tribes for thirty years do have the option of manageing part or all of their health care under the Self-determination Act. What the DHHS secretary is doing is reafirming Presidents Obama commitment to Indian peoples health and their soverignity.
29405417lacy said on Sunday, Sep 20 at 3:08 AM
i hope this helps the tribes in need, our people should of been first to all good benefits instead of being considered lower than an animal
29390957Robert Nakai said on Friday, Sep 18 at 11:31 PM
It can be realized after we started the work for revision of the Indian Health Care Improvement Act over 10 years ago in updating the Act. This administration and members of congress can still do the right thing by passing the updated Act. Our native people still are due the full services of all health service regardless of who provides it. However, it is imperative that qualified health professionals manage the health services and non-health professionals work in their educated fields.
29358207Native Guy said on Friday, Sep 18 at 6:40 PM
it's a great time to share information by our many educated natives with all native people, its our obligation, As for those young native internet junkies, we need to make them think of what is being lost in their times!
29350027Return to tribal nations said on Friday, Sep 18 at 4:32 PM
ALL educated natives need to return back to their people and help them out. Educated natives need to develop the proposals to ensure their people have the necessary health and environmental care for generations to come. Make the change, be the difference. Address issues of historical trama and sue the U.S. Federal government under the United Nations Human Rights Commission. We need to change how we deal with Govt-to-Govt relations. We should be using International Law on government relations.
29344942WARRIOR WOMAN said on Friday, Sep 18 at 4:15 PM
tribes have chosen to disengage from IHS, my tribe included. We now pay for the majority of dental, glasses, and other services that were considered routine and free prior to the change. Elders have been notified that they no longer are eligible for tribal clinic services, because they hadn't updated their records.WHAT??Most are on fixed incomes, and on the Rez not much ever changes, especially income-wise. Noone was aware that they had deadlines on paperwork, or anything else....!!
29344117phil savilla said on Friday, Sep 18 at 2:30 PM
with the reform in health care why do we still need an Indian Health Service which doesn't have the financial resources it needs anhyway to amke a difference indian country. let the tribes manage their own health care under the reform.
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