Administration Pushes Back After Being Labeled Cheaters on Health Costs
Indian Health Service (IHS) officials are pushing back against tribal concerns over an Obama administration plan that would cut contract support cost (CSC) reimbursements to tribes as part of the federal budget’s continuing resolution currently being considered by Congress.
At least 45 tribes and tribal organizations have written to Congress, asking for protection against the proposal, which they say cheats tribes out of millions of dollars they are due. They believe the proposed tribe-by-tribe federal cap on CSC funding would wipe out tribal legal claims and put tribes in the difficult position of being required to spend large amounts of money to administer contract support programs without providing them the funding to do so.
IHS leaders say the tribal concerns have been heard, but the administration believes the plan still needs to be implemented by Congress due to federal budget concerns and sequestration.
“The Administration’s decision was made after careful consideration of all views,” Dianne Dawson, a spokeswoman for IHS, told Indian Country Today Media Network by e-mail. “This option is a short-term approach in this difficult budget climate and is consistent with the Supreme Court’s decision in Salazar V. Ramah Navajo Chapter. We are currently consulting with tribes to find a long-term solution for CSC funding.”
Tribal leaders, concerned that they will be shortchanged millions of dollars, are not moved by the administration’s response, and they say it opposes the June 2012 Salazar v. Ramah Navajo Chapter ruling by the U.S. Supreme Court that said the federal government must pay for the full CSC incurred by tribes while providing healthcare and other governmental services for their tribal citizens through Indian Self-Determination Act contract agreements.
“Our views were never asked for, and so the only views that were considered were views within the administration,” Edward Thomas, president of the Central Council of Tlingit and Haida Indian Tribes, told ICTMN after reviewing the administration’s response.
“This proposal should never be a short-term solution without clarifying what the impact would be,” Thomas added. “[This] interpretation of the Supreme Court decision as a budget or financial issue is wrong and not consistent with promises made by the President to not try to balance this nation’s budget on the backs of the less fortunate.”
Thomas noted that tribes have interpreted the Supreme Court decision to mean that finally the federal government must pay for the cost of tribes administering programs on their behalf. “The Supreme Court ruled in Ramah that the U.S. must pay 100 percent of our tribal CSC costs,” he said. “Maybe President Obama should tell his officials to read Ramah again and again until they get it. It appears to me that White House OMB [Office of Management and Budget] is opposing the President indirectly and this should never happen.”
Thomas said the right “long-term solution is to put 100 percent funding of indirect costs into each and every budget. It isn’t complicated. This can easily be absorbed by the administration.”
Lloyd Miller, an Indian affairs lawyer with Sonosky Chambers who represents several tribes with pending CSC claims, says that the administration framing of this situation as a budget issue is flat-out wrong. “A special account exists in the Treasury to pay any claims over contract shortfalls,” he said. “No other government contractors are being treated this way. The administration's proposal to cut off tribal contract rights is nothing less than racial discrimination.”
Added Miller, “They seem to think that tribes are comfortable with treating contracts to operate government facilities as mere grants, with the tribes happy to cut services if the promised payments fall short. That is a bad miscalculation. Tribes have far too much knowledge of broken treaties, and they will not sit still while IHS seeks cover to break its contract obligations.”
In light of the administration’s response, Congress members are vowing to continue to fight the proposal. Republican leaders chose not to include the language in their continuing resolution proposal released September 10, but that legislation is on hold, since some conservative members of the Republican caucus want the continuing resolution to include language that would vote down Obamacare. The Senate has yet to decide if it will take up the CSC plan.
There will be a partial government shutdown if Congress can’t pass a continuing resolution by October 1.
Rep. Don Young (R-Alaska), chair of the Subcommittee on Indian and Alaska Native Affairs, has taken the lead against decrying the administration’s CSC proposal, and he says their new rationale rings untrue.
“The administration is claiming that their proposed hard cap on contract support cost funding is both short-term and consistent with Ramah, and their claim is false on both fronts,” Young told ICTMN. “Their proposal would deny tribes compensation that they are rightfully due and has harmful long-term implications for health care delivery throughout Indian country.”
Young said that the tight federal budget “may continue to exist long into the future,” yet it “does not diminish the federal government’s trust responsibility.
“The real problem is not the budget climate, but the administration’s unwillingness to prioritize Native healthcare,” Young said.