"If we have health care reform it should include our first Americans," Rep. Martin Heinrich says. While health care is snarled in Washington, two of New Mexico's congressional members say they're committed to getting the Indian Health Care Improvement Reauthorization and Extension Act passed during the second session of the 111th Congress. But, reaching an agreement on the act could be complicated after the election of Scott Brown to the senate last week.
"People don't know what's going to happen," Rep. Martin Heinrich said on Wednesday as he prepared to attend the president's State of the Union address. "There's a lot of uncertainty until we know exactly what the process is moving forward."
While there does not appear to be a clear path for the IHCIA, which expired eight years ago, both Heinrich and Sen. Tom Udall said that they are "ready to go at it again."
"The fact that the House and Senate have passed it in previous sessions -- I think -- means there's some good bi-partisan support for this," Udall said in a telephone interview. "We should be able to get it in the next version of health care [reform] as a freestanding bill or joined with something else -- depending on what other legislation comes up this year."
Indeed, the act, which was last reauthorized in 1992, appears to have support from people on both sides of the aisle.
"If we have health care reform it should include our first Americans," Heinrich said. "This is important to people from places like Alaska where their delegation is Republican, and it's important to people from places like New Mexico where we've got a Democratic delegation."
Living up to treaty obligations
Udall, a co-sponsor of the senate amendment that placed the IHCIA into health care reform package, has said it would allow the United States to “live up to its treaty obligations.”“We can’t truly address the health care crisis in our country without improving health care for all of our citizens, and that includes the 1.9 million American Indians and Alaska Natives whose health care is coordinated through this act,” Udall said last Fall.
In October, when it appeared the Democrats had the votes to pass health care, Heinrich sent this letter to house leaders and urged them to include the reauthorization act as part of comprehensive health insurance reform.
At the time, Heinrich wrote, "Our country desperately needs health insurance reform — but our pursuit of reform cannot leave Native Americans behind,” Heinrich said. “I represent tens of thousands of Native Americans in central New Mexico, and my constituents have made it clear that they cannot wait any longer for health care reform in Indian country.”
Still optimistic
Today, nothing has changed in Heinrich's mind, and he said he's "optimistic if there is a package that comes out of the house and senate that it [IHCIA] will be a part of it. That's certainly what I've been advocating to the leadership of the House."Heinrich insists he does not regret tying the measure to the comprehensive reform bill, because the House Natural Resources Committee, where he is a standing member, has already passed the IHCIA as a stand alone piece of legislation.
Udall said the IHCIA would be included in the senate's next version of health care -- either as a freestanding bill or joined with "something else of a health care nature depending on what other legislation comes up this year."
As a last resort, Udall said it could be attached to bills at the end of the year to "get things done that we all know need to be done."
Fixing health care disparities
"There's no doubt if you ask all 22 New Mexico tribes they'd say this is their top priority," Udall said. "There are very severe health care disparities on natives lands."
Remedying those disparities is why Udall insists the act needs to be reauthorized this year.
"The important thing is that the health care delivery system is underfunded," Udall said. "In the last 10 years there's been a rapid of health care technology. In this case we have outdated technology in place in many of these institutions. The update moves us forward in terms of prevention. It moves us forward on the diabetes and obesity epidemic. There are many things that move the health agenda forward for native Americans in this reauthorization and we need to get this done."In fact, last December, on the senate floor, Udall said health care for Native Americans was in dismal shape and quoted from a Civil Rights Commission study that showed annual health care spending on Federal prison inmates was double the amount spent on American Indians.
"Inmates have better health care than the population with whom we signed treaties and made a promise to provide health services," Udall said. "Right now in Indian Country, the health care situation is dire. Native Americans are diagnosed with diabetes at almost three times the rate of any other ethnic group, they often don't have access to preventive care, and Native youth are attempting and committing suicide at alarming rates
Better chance for passage this year
The originial amendment authored by Natural Resources Committee Chairman Nick Rahall, D-W.V., would reauthorize the program until 2025 and make the most urgent reforms to the program.
After attending the President Barack Obama's first State of the Union speech both Udall and Heinrich could feel a little better about their chances to get the act through congress this year after
Obama appeared to breath new life back into the health care debate during his speech on Wednesday night.
"Let us find a way to come together and finish the job for the American people," Obama said. "Let's get it done. Let's get it done," he repeated.
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