Officials Concerned About Sequester Effects On Indian Health Services

The state of Indian Country is strong, according to the president of the National Congress of American Indians. Today Jefferson Keel presented the State of Indian Nations Address in Washington D.C.

Despite advancements in tribal governing, leaders are worried about the coming sequester, and what it means for Indian Health Services.

Keel rattled off a long list of recent successes – from the Cobell settlement to record levels of energy production in Indian Country to stronger government to government relationships.

But he made clear the near future will be difficult.

“The trust responsibility is not a line item. And we are not a special interest group,” Keel said.

He went on, warning that the coming budget cuts could devastate essential services to Natives.

“We urge Congress to acknowledge their Constitutional responsibility to honor our sacred trust by holding tribal governments harmless in the sequester and beyond. As President Obama said in the State of the Union Address, just two days ago, the federal government must keep the promises they’ve already made,” Keel said.

The sequester is set to take effect March first. On that date, government agencies will need to start cutting at least eight percent of their budgets.

Yvette Roubideaux leads the Indian Health Service. She says the sequester would slash nearly all aspects of the federal government, but the effects would hurt most in native communities.

“Three-thousand inpatient admissions and 804,000 outpatient visits would have to be cut to be able to absorb the sequester,” Roubideaux said.

Keel put a more human face on the figures, saying the cuts to IHS would hit at the community level – not just jobs in Washington D.C.

“It will affect whether or not a young mother will be able to access healthcare for her unborn child. It will affect whether or not elderly people will be able to afford their medications, or whether they’ll be able to go to the doctor,” Keel said.

Keel says he’s trying to sway members of Congress to exempt Native services from the sequester. But there isn’t much time.

Haines native Jackie Pata is the executive director of NCAI. She originally thought IHS would be exempt from sequester. Now’s she’s preparing tribes for all sorts of cuts – beyond healthcare.

“We’ve been talking with tribes a lot about things like lean management, how to take on some of those principles and really scale to address our most critical needs and be efficient and effective with the federal funds we do have in our communities,” Pata said.

And regardless of what happens with the sequester, federal budgets need to shrink because of the Budget Control Act.

That means all sorts of Native services will feel the pinch. The new chair of the Senate Indian Affairs Committee, Washington Democrat Maria Cantwell, made clear that the Committee has a full docket.

But getting appropriate funding for any of them will be hard.

“The Native American Self Determination Housing Assistance Act expires this year. We have a Farm Bill that we need to reauthorize. The elementary and secondary schools act which expired in 2008 is well past its due date for reauthorization. The issue of tax reform and making sure the IRS deals with tribes in a fair way on taxation issues,” Cantwell said.

Most in Congress publicly say the sequester will happen, what’s unclear is whether it will be permanent. Congress could pass a fix once the cuts go into effect.

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