Making Progress for Native American Communities

Nancy Pelosi

“If you knew the conditions and circumstances…you would do all you could to remedy them.” These were the words written by Dr. Susan La Flesche Picotte—the first Native American woman to earn a medical degree—in 1907. Her letter appealed to the federal government to act to address a lack of health-care resources for her Omaha tribe, to send more medical professionals to her people, and to stem the spread of disease among local children.

Her clarion call reflected a broader outcry from Native Americans across the U.S. But these pleas would go almost entirely unanswered. The necessary remedies failed to arrive. The conditions and circumstances continued to deteriorate.

Too often in the century since Dr. Picotte’s letter, our government’s response to the struggles of Native Americans has still come up short, and its actions have not done enough to alleviate issues of health care or poverty.

Yet today, the situation is starting to change for the better. Under Democratic leadership, we are no longer turning a blind eye to the conditions and circumstances in Indian country. We are working to remedy them: by improving health care for Native American families and by fighting to protect Native American women from violence and abuse.

More than two years ago, we enacted the Affordable Care Act to put consumers in charge of their own health future—with greater accountability for insurance companies, lower costs for patients, and more access to quality care for every family.

In one of the most critical reforms for Native American communities, the Affordable Care Act permanently reauthorized the Indian Health Care Improvement Act—to help build hospitals, train nurses, and ensure healthy moms and babies in tribal communities.

The law will mean expanded Indian Health Service (IHS) services, including mental and behavioral health treatment and prevention. It will mean more clinicians serving Native Americans and rural areas. It will mean that tribes and tribal organizations will be able to purchase federal insurance coverage for their employees.

Already, millions of Americans, including Native Americans, are enjoying the benefits of new patient protections at the center of the Affordable Care Act.

As we are witnessing in communities across the country, Native American seniors are seeing the “doughnut hole” close and their prescription drug costs drop, while receiving access to critical preventive services free of charge. Native American children can no longer be denied coverage due to pre-existing conditions; young adults can stay on their parents’ health plans until age 26; and small-business owners are getting tax credits to help provide insurance to their employees.

As the law fully takes effect, Native American families will have new health-care choices in state-based insurance exchanges, and lower-income households will no longer face co-pays at the doctor’s office. Medicaid will expand and help extend the reach of Native American health initiatives. Stronger reimbursements from Medicare, Medicaid, insurers, and others will help the Indian Health Service fund needed services across the board.

Health reform is central to our effort to improve the quality of life for Native Americans. But it’s not the only step we can, and must, take. Right now, too many Native American women face domestic violence and abuse in silence, in the shadows. Yet today, with the fight to reauthorize the landmark Violence Against Women Act (VAWA), we have an opportunity to remedy these conditions once and for all.

The U.S. Senate took the first step, when they passed a bipartisan reauthorization of VAWA that would enable Native American women to hold abusive partners accountable for violence. It gives tribes and law enforcement the tools to address these crimes at the local level, and seeks to stop abuse in Native American households in the early stages, before it leads to severe physical injury or death.

These provisions of the bipartisan Senate-passed VAWA bill are essential to the health and safety of Native American women; yet the House Republican version of the bill left them out. This is simply wrong and unacceptable, and Democrats will not let this stand. We will fight for passage of a law that gets the job done. We will fight to ensure that Native American women get the same protections as all American women.

In closing her letter to the Commissioner of Indian Affairs, Dr. Picotte noted that “the financial outlay for…these…requests is but small compared to the amount of good it will bring forth to my people.”

She was right then, and her appeal rings true today. We must keep working to remedy the conditions and circumstances of Indian country in our own time. Together, we must uphold our moral obligations to the health, safety and prosperity of all Native Americans.

Nancy Pelosi, the first woman Speaker of the House, is the current House Democratic Leader.

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tmsyr11's picture
So much for the 'first', she was ousted and replaced in CONGRESS. Let's all NOT FORGET her famous words (as this is a FACT and it really did happen much to her dismay): the Nancy Pelosi remark: “But we have to pass the [health care] bill so that you can find out what’s in it….”. Grandma Nan from San Fran of course was referring to the "Affordable Care Act" as Obama-care. IF INDIAN HEALTH CARE was so important, why didn’t DEMOCRATS (in charge of Federal Govt from 2008-2010) act on Indian care as a separate issue? Now talk on Nancy Pelosi's wealth - we'll talk about that another time....
andre's picture
Nancy Pelosi, makes some very good points in this article. Too bad they are only talking points. The same chronic, systemic issues she describes here are the stuff legends are made of. As the former Speaker of the House, and a veteran career politician, she has had ample opportunity to be the needs of Indian country in a higher priority than it has been, but yet, chose not to. I have never seen her champion nor weigh in on any fight for Indian country. Nancy needs to be reminded that words are empty when not accompanied by a corresponding action. But then again, it's an election year. I doubt she has ever lived in an economically depressed area, hauled water, used an out-house, managed to survive with 5 people living in a 2 bedroom single-wide trailer, or waited hours for police services.
smartphoenixnavajo's picture
American Indians have always and will continue, to always fight for everything we have. We even fight them to keep their word, which is even leaglly written in most cases. While this a a known fact, I do applaud the efforts for the full VAWA Law. This one way street must end. Any and everyone who commits any crime against property and/or people must be held accountable in that jurisdiction where said crime occurred. Next is this "free of charge" statement. How many of us have heard this? Nothing, absolutely nothing, we recieve is free. We have and continue to pay. I know its not the legal tender people are used to now, it was and is more. In acreage alone, its billions and thats just the surface rights, so knock off the , "its free" stuff. Last is the "improve the quality of life". How many american indians have no teeth by the time they are fifty? Oh but thats "cosmetic" to the IHS. Yeah, so the quality of life is is improved when you cannot eat over half the food thats cooked in america. We all know this is pure political canine fecal matter and things will go on as they are. What we really need are more american indian health professionals and preventive care, so at least we will have teeth and enjoy some bison when we are sixty.
dinagw's picture
I'm still trying to figure out how Obama-care is going to help me. So far, it hasn't done a thing. Pelosi talks about more clinicians serving rural communities.....well, from what I can see, it's the rural communities (on the Rez) that are getting all the money. That's great for them....I love to see all the beautiful new clinics on the reservations as I travel through Indian country. But I live in a large urban area in California which has more Indians than any other state, but the nearest IHS clinic is 60 miles away. While I'm grateful for it, all I get is the most basic of services, many of which I have to pay for. If I get really sick, forget it. I have no insurance because I can't afford it. The problem is that the US' history of forcing Indians into cities to assimilate has left us high and dry...the trust responsibility for healthcare to those of us most impacted by forced assimilation is not being honored. No one is talking about that. Instead, under Obamacare, we are being told, like everyone else, that if we don't buy health insurance (which we may or may not be able to afford) we will be penalized. If we opt out under the Native American clause, we're still stuck with no healthcare. I really can't see how Obamacare is going to live up to the trust responsibility for us urban NDNs. Anybody else got this figured out?