Medicaid, Health Care, Indian Country


Senate Proposes ‘Devastating’ Health Care Bill

No Tribal Consultation, Note Sens. Tester, Udall

After weeks of closed-door meetings, 13 Republican senators have come up with a draft health care bill as mean-spirited and destructive as the proposed House legislation to repeal and replace the Affordable Care Act (ACA) of 2010, aka Obamacare, passed on May 4.

Senate Committee on Indian Affairs (SCIA) member Jon Tester, D-MT, emailed ICMN this comment, “This bill was written in secret without any input from folks in Indian country. It will rip away Medicaid for thousands of Native Americans, make it harder to get coverage if you have a pre-existing condition like high-blood pressure or diabetes, and further strain local IHS and tribal health facilities.”

Sen. Tom Udall, D-NM, said in a statement: “Native Americans would be among those hardest hit by this disastrous Senate TrumpCare bill. As vice chair of the Senate Indian Affairs Committee, I’ve heard from many tribes who are deeply concerned about the lack of tribal consultation in TrumpCare – and about how devastating this bill would be for access to life-saving health care services in Indian country.”

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Download our free report, Intergenerational Trauma: Understanding Natives’ Inherited Pain, to understand this fascinating concept..

The Senate released its draft health care bill on June 22. The legislation would continue to fund Medicaid expansion for three years and then initiate federal funding cuts beginning in 2021. In some states – Arkansas, Illinois, Indiana, Michigan, Montana, New Hampshire, New Mexico, and Washington – Medicaid expansion could end immediately if federal matching rates go below the rates promised in the ACA.

“The overall goal of health care reform legislation should be to provide all Americans with access to patient-centered health care and health insurance at an affordable rate. We are reviewing this legislation to determine whether it meets this standard and we also want to see a CBO score on the bill,” said Sen. John Hoeven, R-ND, who is chairman of the Senate Committee on Indian Affairs, in an e-mail to ICMN. “We need to stabilize the health insurance market to make it more competitive so consumers have access to better and more affordable health care policies. At the same time, we need to ensure that low-income individuals, have access to health insurance either through Medicaid or through tax credits based on age and income. We’re reviewing the policies in the bill to ensure that Medicaid is sustainable in the future and can work for those who rely on the program.”

States would receive Medicaid funding in the form of a block grant with a set amount of money allowed for each person enrolled in the program. Increases would be indexed to inflation, not to the cost of medical services as they are in the ACA, beginning in 2025. Even though these cuts are more gradual than those proposed in the House bill, they end up being more drastic.

Sen. Al Franken, D-MN., a member of the SCIA, wrote in an email to ICMN, “Just like the health care bill in the House of Representatives, the Senate Republican’s plan would still destroy Medicaid as we know it. In Minnesota, we’ve seen expansion of the program make it possible for Indian Health Services (IHS) to provide more local and comprehensive treatment for members of our tribal communities. IHS funding is still not where it needs to be, and I find it alarming that the Republican health care bill would actually make deeper cuts to Medicaid over a longer period of time to give billions of dollars in tax breaks to the very few richest Americans. This is unacceptable.”

In an email, a spokesman for Sen. Steve Daines, R-MT, a member of the SCIA, has a more positive view, “The discussion draft leaves the Indian Health Care Improvement Act (IHCIA) intact. It fully funds the Montana Medicaid Expansion, which is scheduled to end in June 2019. It would provide financial support for low-income tribal and non-tribal members for the purpose of purchasing insurance, if they are not eligible for Medicaid.” Daines said, “I’m glad to see the draft text of the bill made public for everyone to see. I look forward to hearing directly from Montanans on this legislation, including on the 17th teletownhall I’ll be hosting next Wednesday (June 28).”

The ACA’s federal subsidies to help people who don’t qualify for Medicaid to pay for health insurance would be greatly reduced under both the Senate and House bills. In the Senate version, subsidies would not be available for people earning more than 350 percent of the poverty level. Under the House version, tax credits to help pay insurance premiums would be based on age, not income, and would top out at $4,000.

Under the ACA, all insurance plans are required to pay for essential health services, such as hospital stays, maternity coverage and mental health treatment. Both the Senate and House bills allow states to define what essential services insurance companies must cover.

Sen. Martin Heinrich, D-NM, said in an email to ICMN, “The health care bill that Senate Republicans released would be devastating to tribal communities who have long faced challenges with access to affordable health care, insurance, and services. It would strip billions from Medicaid and effectively end Medicaid Expansion, which has been the primary driver for increasing health coverage for Indian country over the last few years. Americans living in rural and tribal communities would lose access to health coverage that has helped their families—and in some cases even saved their lives.”

Intergenerational Trauma: Understanding Natives’ Inherited Pain

Download our free report, Intergenerational Trauma: Understanding Natives’ Inherited Pain, to understand this fascinating concept..

The Congressional Budget Office is expected to review and score the Senate bill this weekend and a vote could come as early as next week, before Congress adjourns for its July 4 recess.

Tester said in his email to ICMN, “Politicians in Washington must understand that providing access to quality health care in Indian country is more than a talking point, it is a trust and treaty responsibility to Native American families.”

You may phone or e-mail your senators to let them know what you think about the proposed legislation. Go here. In the upper left hand corner is a link to “Find Your Senators.” Select your state from the drop down menu and the next screen will show your two senators’ names along with their phone numbers and links to their emails.

RELATED: Catastrophe in DC: Proposed Medicaid Cuts Would Severely Harm Native Health

  • What’s with the title of this article?
    Why do you choose to create so much drama in Indian country?
    Why should Native people be upset by any of this?
    Since when should Native people, or anyone, be so dependent on the federal government?
    I thought as Native People, we were the ones who understood what real freedom was all about?
    How can anyone claim to be “free” if they’re so dependent on a bloated federal government?
    I think Trump’s original intent re health care, and all matters, is to decrease the size of the federal government and give more control to the states. Isn’t local governance better than distant? Whether Congress understands Trump’s desires and helps him or obstructs him is another matter.
    On another note: Is Indian Country Today just another mouthpiece for left extremism that hates all things that doesn’t come from themselves? I would think that all Natives would realize that as sovereign nations, they shouldn’t be aligning with any political party of their oppressors, nor should they be counting on being dependent on their oppressors, nor should they count on their oppressors for anything. You can’t claim to be a sovereign nation and yet be like children who still need to suckle off the breast of others.
    It’s time for everyone to grow up … including Natives and Indian Country Today, and start claiming their own self-reliance, their own self-worth, their own future.
    Modern science is now confirming much of what is known as ‘traditional’ medicine and herbology. You certainly don’t want to get roped into today’s corporate-health-care garbage that never really heals anything, but does create opiate addicts, and premature and unnecessary deaths due to their lack of understanding of what real health care is due to their over-the-top greed.
    Why would you care to be a part of that? Or to have it ‘mandated’ so that you’re forced to be a part of it?
    I can tell you this: I haven’t been a part of any government health care system in over 20 years. I’m not dead, and am probably healthier than most people my age. Meanwhile, I have known several elders who subscribed to Obamacare who are no longer with us. Why? Because according to Obama’s plan, they were no longer ‘economic producers’, and therefore, dispensable, and were not treated to heal or enhance their health, but were basically just sent home to die.
    Is that what you want for your elders or yourselves?
    Time to wake up and see what’s really going on.
    I remember a time, within my own lifetime, when people could negotiate a private contract with a private physician to provide health care services for themselves and their family. My father did it. Health care was far far less expensive at that time. Why? Because there weren’t countless numbers of people involved. No government bureaucracies to support.
    If you insist on being a child in a nanny state, and don’t have the maturity to negotiate your own contracts with your own healers, then you will never be a ‘free’ people. It’s just that simple.
    Indian Country Today is doing a real disservice to Native people if it isn’t promoting avenues that lead to real freedom.

  • Grant R.

    You guys need to knock it off with this devastating health care bill malarkey. Where is your honesty? Obamacare is dead in the water and you say nothing about that? Your fighting something that could very well bring us large benefits to our People and all you can do is criticize? You all have a large responsibility to tell the truth not what you think will advance your political ideology. Your either in this fight for the betterment of ALL the people or your just another Red Apple with no sense of Honor and you need to get a job that facilitates your ignorance.

  • Anna Marie B.

    As a fellow human being I refuse to “Sugar Coat” my comment – the proposed Senate TrumpCare Bill lacks compassion, empathy, and shows a complete lack of disregard for the overall well being of citizens of this country ( Sovereign, white/black, etc.) and it seem as if politicians are playing ‘ ‘Roulette’ with people’s lives – literally millions of people will be adversely affected if ‘TrumpCare’ passes. I can’t figure out exactly why things were discussed behind closed doors regarding this important issue. These actions, all are UNACCEPTABLE.

  • Anna Marie B: Your comment lacks specifics but is full of extreme left wing drama. Have you actually read the bill? or are you just parroting what you’ve heard others say?
    Be careful of who you follow. The U.S. and ALL it’s media is full of deception …. it is owned and/or funded by globalists who don’t know you, and care nothing for you at all, not at all. But they do count on people who don’t take their own time to study the issues to be their mouthpieces as they brainwash the masses with their baseless hysteria. And the ignorant masses repeat it to themselves and each other.

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Senate Proposes ‘Devastating’ Health Care Bill