Advocates Fail To Win Passage of American Indian Health Care Improvement Reauthorization Bill

A host of American Indian health care advocates, tribal leaders and other supporters have "admitted the defeat" of the Indian Health Care Improvement Act reauthorization bill (HR 1328) after several attempts to bring the legislation to a vote failed late last month, according to a statement posted on the National Indian Health Board Web site, Indian Country Today reports (Reynolds, Indian Country Today, 10/3). The House Energy and Commerce Health Subcommittee approved the legislation last year to extend the act through fiscal year 2017. The bill was intended to improve health care for American Indians and Alaska Natives (Kaiser Health Disparities Report, 11/8/2007).

Last month the NIHB attempted to attach the bill to a continuing resolution (HR 2638), but the effort failed. NIHB also tried to move forward smaller parts of the larger bill -- including amendments that would have improved American Indian/Alaska Native access to Medicare, Medicaid and SCHIP -- as a stand-alone bill, but that effort also failed (Indian Country Today, 10/3).

NIHB said on its Web site that it "worked tirelessly" to get the bill approved, but after "several legislative strategies, ... our efforts were shut down because Congress could not find funding to pay for the bill." NIHB added that it "will continue to pursue legislative strategies during the remainder of the 110th Congress."

The Congressional Budget Office has said the House version would have cost $9 million for the first year, $53 million over five years, and $129 million over 10 years, according to NIHB. The statement continued, "Unfortunately, House Leadership was not able to fund the first five years of the bill in an amount of $53 million" (NIHB statement, 9/29).

Reasons for Failure
According to Indian Country Today, the House decided not to bring the bill to a vote because of an amendment added to the Senate version by Sen. David Vitter (R-La.) that would have codified restrictions on the use of federal funds to pay for abortions. American Indian lobbyist Tom Rodgers of Carlyle Consulting said abortion-related issues surrounding the amendment "dominated and clouded the whole debate."

Rodgers added, "Indian country needs to have more allies on the (House) Energy and Commerce Committee. It is basically an urban committee which does not reflect historical ties to Indian country." Rodgers said supporters and lawmakers will develop new strategies to get the bill passed during the next Congress (Indian Country Today, 10/3).