Ensuring quality health care for Alaska Native people

Posted: Tuesday, April 06, 2010

No reform of America's health care system would be complete without addressing the health needs of the nation's First People. That's why I insisted that the final health care reform bill include long-overdue reauthorization of the main health law for Alaska Natives and American Indians.

Originally enacted in 1976, the Indian Health Care Improvement Act (IHCIA) provides legal authority for the delivery of federally funded health care to our nation's first residents. It is a significant law, but for nearly a generation it had not been reauthorized. This inaction by Congress was a source of frustration for many Alaskans.

In early December, the Senate Indian Affairs Committee approved a bill for consideration by the full Senate that would permanently reauthorize and expand existing health programs for Alaska Natives and American Indians.

Still, there was uncertainty. So I joined ten of my colleagues in strongly urging Senate Majority Leader Harry Reid to include reauthorization of the IHCIA in our comprehensive health care reform bill. Senator Reid complied, and on Christmas Eve I was proud to cast my vote for this historic piece of legislation. It was signed into law by the President on March 23.

The need for reauthorization is crucial. The last comprehensive reauthorization of IHCIA took place in 1992.

Since then, the American health care system has been greatly modernized. However, the Indian health care system has not kept pace. Now, thanks to reauthorization, the IHS is empowered and better equipped to address the health disparities of American Indians and Alaska Natives through:

• Long-term care, including home health care, assisted living, and community-based care for the elderly.

• Establishing a continuum of care for integrated mental and behavioral health programs beyond alcohol and substance abuse (such as fetal alcohol spectrum disorders, and domestic violence prevention programs).

• Requiring the IHS budget to account for medical inflation rates and population growth, in order to combat the dramatic underfunding of the Indian Health System.

• The recruitment and retention of qualified Indian health care professional and providing loan repayment incentives for providers who work in underserved areas, including in Alaska.

• Updated methods of preventative screenings.

• Protecting Alaska Natives from penalties for not acquiring insurance, expanding coverage to public programs, and promoting innovative programs like Southcentral Foundation's Nuka Model of Care.

In a related bit of very good news, we just learned that Alaska's tribal health organizations have been awarded nearly $37 million in increased funding for "contract support costs." These dollars help tribes achieve self-governance and help cover health delivery and other program costs.

Although some people have raised concerns on how the larger health care reform bill will affect the IHS, I want to assure you it will in no way detract from or diminish health care delivery. In fact, this bill strengthens care available for Alaska Natives.

For more information on health insurance reform, visit my website at http://begich.senate.gov.

• Mark Begich is a U.S. Senator representing Alaska.

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