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IHS proposes caps as federal budget deadline nears

Alaska's congressional delegation, Alaska Native leaders fight for full funding

Posted: September 18, 2013 - 12:09am

The Obama administration is proposing caps for funding operational costs at tribally run hospitals and clinics. It’s an issue that pits a traditionally underfunded division of the federal government against the tribes it’s supposed to be advocating for.

Opponents of the proposal say that the caps not only underfund tribal hospitals and clinics, but that it also defies a June 2012 Supreme Court decision that says that the federal government is contractually bound to fully fund operational costs or contract support costs. The Indian Health Service says the caps are a short-term solution that keeps the department within it’s budget and that the proposal does not defy the Supreme Court’s decision.

Programs such as Medicaid, the Children’s Health Insurance Program and Social Security were exempted from sequestration; IHS was not and its budget was cut by 9 percent.

Congress has long underfunded tribal healthcare organizations across the country. After 22 years of litigation, the Supreme Court decided in Salazar v. Ramah Navajo Chapter that the federal government was obligated to fulfill its end of the trust relationship that it has with tribes.

Since the Ramah decision, Alaska’s congressional delegation has been especially active in advocating for the IHS to fully fund the tribes for the costs they incur while providing healthcare to tribal members. 

Alaska Senator Lisa Murkowski said in an interview Tuesday that she’s disappointed in IHS Director Yvette Roubideaux and the Obama Administration.

“When the Ramah decision came down, it was a time for real celebration,” Murkowski said. “To finally be vindicated by the courts only to then have the administration — an administration that has said they would work twice as hard to keep the promises they made to our first people — ask (the tribes) to do more with less is just wrong.”

Murkowski said she was angered when IHS said that it had consulted with the tribes about the proposal.

“To me it was stunning when the IHS came out and said they were going to take this path,” Murkowski said. “They claimed that this was consistent with the law and then they went further and said that they consulted with the tribes about this. That’s when everyone came unglued. I don’t think that there has been any tribe that has not spoken out strongly and clearly.”

Tlingit-Haida Central Council President Ed Thomas was in Washington D.C. Tuesday to speak with the Alaska delegation about the IHS proposal. Part of the proposal calls for payments from the IHS to the tribes to settle claims for years of underfunding. The IHS has said it will make one time offers to tribes that are non-negotiable. If a tribe declines the settlement, then it can go through an appeals process. Thomas said he is against settling.

“I think the offer should be full payment. That’s the only way that’s acceptable to me,” Thomas said. “We’re managing these contracts and we’re not getting paid because they get to say ‘Gee whiz, maybe we’re a little short on money.’”

Thomas said he also takes issue with the IHS for saying that they consulted with tribes on the proposal.

“I really do not agree with their interpretation with the term of consultation,” Thomas said. “What they’re doing now is saying ‘we’ve made our decisions, now lets talk.’ That’s not consultation.”

Congress must pass a budget resolution by Oct. 1 or face a government shutdown

• Contact reporter Jennifer Canfield at 523-2279 or at jennifer.n.canfield@juneauempire.com. Follow her on Twitter at https://twitter.com/canfieldjenn.

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