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Sen. Mark Begich (D-Alaska) wants answers from the president.

Sen. Begich Urges Obama’s Attention on Plan to Cheat Tribal Health Costs

Rob Capriccioso


Another Democratic senator is putting heat on the White House to live up to the federal trust responsibility to tribes by paying full contract support costs (CSC) owed to tribes for health services.

RELATED: White House Trying to Cheat Tribes on Health Costs

Sen. Mark Begich (D-Alaska) wrote in a letter to President Barack Obama November 8 that he wants the White House Office of Management and Budget (OMB) to stop pushing a budget proposal that would authorize the Indian Health Service (IHS) and the Bureau of Indian Affairs (BIA) to limit how much each tribe would be paid for CSC reimbursement.

Begich further asked the president to convene a meeting between tribal officials and the OMB to consider ways “to fully fund these costs,” and he requested a settlement process for resolving millions of dollars in unpaid past CSC to tribes. The senator is also proposing an amendment to the Indian Self-Determination and Education Assistance Act that would facilitate a CSC settlement process and would appoint a special master to oversee it.

“America’s tribes are frustrated with the lack of resolution of this issue and both they and I have written numerous letters to your administration seeking a solution,” Begich wrote to the president. “Some of these claims extend back more than 20 years.”

Dozens of tribal leaders have made similar requests to the administration, which have fallen on deaf ears to date, with the federal agencies defending the plan that potentially avoids paying millions in CSC to tribes, despite a 2012 Supreme Court decision that says such reimbursement is necessary.

RELATED: Administration Pushes Back After Being Labeled Cheaters on Health Costs

“The U.S. Supreme Court has ruled several times, most recently last summer, that the federal government must fulfill all contracts with tribal governments providing necessary medical and other social services to their members,” Begich noted in his letter, saying that the president should resolve to meet with tribal leaders specifically on this issue.

Begich’s plea follows a September 30 letter from several Senate Democrats and a couple of Senate Republicans to Office of Management and Budget Director Sylvia Mathews Burwell that asked for her agency to reverse course on plans to avoid paying CSC owed to tribes. Burwell has not publically changed her position to date.

Begich’s letter is the latest salvo in an intense policy schism brewing between the Obama administration and tribal advocates in Congress who want to do right by tribes on this matter.

Maria Cantwell (D-Washington), chair of the Senate Committee on Indian Affairs, is also taking up the battle, having scheduled a November 14 Senate hearing, titled “Contract Support Costs and Sequestration: Fiscal Crisis in Indian Country,” just one day after the president’s White House Tribal Nations Conference. Scheduling a hearing that has potential to make the administration look bad on a major tribal issue in a week where the administration wants positive tribal news at the forefront is a signal to tribal advocates that many legislators are unhappy with the administration’s positioning here.

Tribal leaders have been widely concerned that a final federal budget beyond continuing resolutions could include the Obama administration’s desire to cap CSC reimbursement. They say the administration’s plan to date amounts to a tribe-by-tribe federal cap on CSC funding that would wipe out tribal legal claims and put tribes in the difficult position of being required to spend money to administer contract support programs without providing them the funding to do so.

Obama’s 2014 budget request fell $140 million short of what is required to honor all tribal contracts with the IHS, and $12 million short of what is required to honor all BIA contracts, according to testimony provided to Congress in April.

Forty-five tribes and tribal organizations sent a letter September 3 to congressional members of the Subcommittee on Interior, Environment, and Related Agencies, asking them to eliminate the administration’s request from their budget bills.

“If this language is enacted, once again Indian tribes would be the only government contractors in the Nation whom the United States could cheat with impunity,” the tribal leaders wrote. “Worse yet, the Administration developed this plan in secret, without any consultation with the tribes and without any consultation with the authorizing committees.”