Indian Health Care Reauthorized

By Libby Casey

When President Obama signed the health care bill into law today, he reauthorized the Indian Health Care Improvement Act – something that hadn’t been done in two decades.    The reauthorization was rolled into the broader health care package passed by the Senate and House.

The President’s Health and Human Services Secretary Kathleen Sibelius says it’s been a long time coming.

We need to live up to the historic commitments which frankly have been left on the wayside, recognize that the health disparities in Indian Country are quite shocking.

Sebelius says among the changes the White House hopes to make is elevating the job of running the Indian Health Service from an agency director to an Assistant Secretary.

Alaska Senator Lisa Murkowski has worked to update the Indian Health Care Act since she went to Washington eight years ago, and is a prime Republican champion.  She says the fact that the act has now been “permanently reauthorized” gives it more solid footing – and finally improves it.

Think about how health care has changed since the last time we had the health care reauthorization.  We really had no provisions in the Indian Health Care Act as it related to behavioral health, we didn’t have anything in there as it related to long term care.  So what I think permanent authorization means is that we will take it up again as we see changes.

As a Republican, Murkowski voted AGAINST the health care bill President Obama signed into law today.  That put her in the position of voting against the Indian Health Care bill she had advocated.  Murkowski says she would’ve preferred to see it stand-alone, and says she’s “anxious and fearful” that costs associated with the bigger bill will swallow Native health care.

I am somewhat concerned that the Indian Health Service budget may fall victim to just the overwhelming costs that I think we’ll see as a result of health care reform.

Murkowski says she’s also concerned that the reauthorization could get caught up in the legal challenges states are waging against the White House over the broader, controversial health care bill.

Democratic Senator Mark Begich, however, says he’s pleased to see the Indian Health Care Act folded into the bigger bill, and had argued to keep it in back in December when it looked like it might be dropped.  He says it will move projects that were always in the pilot or experimental stage to a more secure position.

Long term health care, long term care for the Native population, issues of behavior health, beyond just alcohol and substance abuse, which is very important.  Suicide prevention programs which were usually piloted in or dropped in.  Now they’re part of the overall delivery system of Indian Health Services.

Begich says the Obama Administration has improved funding for Alaska Native and Native American Health programs… but just because the Indian Health Care Act has been reauthorized doesn’t guarantee its long-term funding, and both Begich and Murkowski – who sits on the Indian Affairs Committee – say pushing for enough money will continue.


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