Dr. Yvette Roubideaux, U.S. Director of Indian Health Services (AP Images)

Dr. Yvette Roubideaux, U.S. Director of Indian Health Services (AP Images)

Obama Administration Enlists Tribes to Fight GOP Health Law Repeal Effort

WASHINGTON – The Obama administration is working with tribal leaders to fight against Republican congressional attempts to repeal the Patient Protection and Affordable Care Act (ACA), which the U.S. Supreme Court upheld last month, including the permanent reauthorization of the Indian Health Care Improvement Act (IHCIA).

“As we all know, the Affordable Care Act included the permanent reauthorization of the Indian Health Care Improvement Act,” said Charles Galbraith, a Navajo associate director with the White House Office of Intergovernmental Affairs, during a conference call set up by the administration with tribal leaders and officials on July 10. “The court has issued a clear and final ruling on the Affordable Care Act, and the last thing Congress should do now is re-fight old political battles and start over on healthcare by repealing basic protections that provide security for the middle class and permanent reauthorization of the Indian Care Health Care Improvement Act.”

Myra Alvarez, a director of public health with the U.S. Department of Health and Human Services, said there were four key points for tribal leaders to share with their communities: 1) the law protects citizens from insurance company abuses; 2) the law spends the nation’s healthcare dollars more wisely; 3) the law strengthens the Medicare program; and, 4) the law offers better access to care.

Broadly, American Indians are exempt from the individual tax mandate called for under the law, which means that Natives are not subject to the Internal Revenue Service penalty for not buying healthcare. Those Indians who wish to participate in the overall program will be able to take advantage of all aspects of the law if they wish, federal health officials have said. Indians who receive care from the Indian Health Service (IHS) will be able to continue to do so, and the law’s IHCIA components are largely aimed at strengthening IHS services.

Yvette Roubideaux, director of the IHS, said it is “fabulous” that the IHCIA is now permanent as part of the overall law. She said she recently initiated a consultation with tribal leaders on healthcare facility construction projects in light of the IHCIA. Her director’s blog lists more information. She also announced that an IHS tribal consultation summit is scheduled to be held starting August 7 in Denver, Colorado.

The IHCIA contains a provision to confer with urban Indian organizations, Roubideaux noted, so she announced that the agency plans to soon post a Federal Register notice that offers a draft policy on the matter.

The call with tribal leaders came a day after Republican leaders of the 112th Congress on July 9 introduced legislation, H.R. 6079, in another effort to repeal the ACA. They have already failed on this front several times before, but have renewed their efforts after the Supreme Court ruling.

The bill, called the “Repeal of Obamacare Act,” makes a variety of arguments against the law, saying that it makes coverage more expensive for millions of Americans, and saying that it cuts more than one-half trillion dollars in Medicare and uses the funds to create a new entitlement program rather than to protect and strengthen the program.

The repeal bill does not contain language on Indian health-related components of the law.

Galbraith said that the White House would not speculate on whether Congress will repeal the law, but said President Barack Obama has vowed to veto any such attempt if it made it to his desk.

The Romney campaign has said the GOP candidate supports a repeal and replacement of the law. While serving as Massachusetts governor, Mitt Romney enacted a similar plan to the ACA in his state.

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