Washington Report

An NIHB Publication

The Washington Report is an e-newsletter produced by the National Indian Health Board. Each issue contains a listing of current events on Capitol Hill, information on passed and upcoming legislation, Indian health policy analysis and action items.

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Located on Capitol Hill, the National Indian Health Board is a dedicated advocate in Congress on behalf of all Tribal Governments and American Indians/Alaska Natives. We maintain a presence in the halls of Congress, working with representatives from across the country to achieve quality, lasting health care for tribal members.

In our efforts to secure quality health care we track legislation and regulations, lead discussions on health care reform, provide recommendations and analysis of the Indian Health Service budget and assist tribes in securing federal funding.

What's New?

Posted - July 30, 2015

Legislation introduced in the House of Representatives to exempt Tribal programs from Sequestration

On July 14, 2015, Congressman Don Young (R-AK) introduced legislation called the Honoring Our Trust Relationships Act (H.R. 3063). The bill would exempt Tribal programs, including the Indian Health Service (IHS) and all programs administered for Native Americans of the Department of Health and Human Services, from across the board sequestration as outlined in the Budget Control Act (BCA) of 2011. Similar legislation has been introduced in the U.S. Senate (S. 1497) by Senator John Tester (D-MT).

As you may recall, the BCA calls for annual across-the-board budget cuts through FY 2021 unless Congress can make a deal to stay below certain spending limits. In FY 2013, IHS lost $220 million due to sequestration forcing IHS, Tribal and Urban health facilities to scramble to keep their doors open. Many cut service hours and delayed or deferred care. With no clear deal in sight for FY 2016 appropriations, it is critical that Congress specifically exempt the Tribes from sequestration.

If you would like to send a letter of support to your Senator or Representative, please Click here (DOC).

Posted - February 10, 2015

Tribal Leaders Visit Capitol Hill in Support of SDPI

Tribal leaders took to Capitol Hill on February 3, 2015 to provide outreach and education to Congress on the Special Diabetes Program for Indians (SDPI). Over 15 individuals participated in visits to 9 Congressional offices. The group met with members of both the House of Representatives and the Senate and included representatives from Cowlitz Indian Tribe; Cow Creek Band of Umpqua Tribe of Indians; Navajo Nation; Sault Ste Marie Tribe of Chippewa Indians; Pueblo of Zuni; Astariwi Band of Pit River Indians; the Santa Ynez Band of Chumash Indians; and the Tohono O'Odham Nation.

SDPI will expire on September 30, 2015, unless Congress acts. The legislation that typically serves as the legislative vehicle for SDPI, the Sustainable Growth Rate Fix (aka the "Doc Fix"), which governs the rates physicians are paid by Medicare, expires on March 31 2015. It is still unclear if Congress will find a way to pay for the overall bill which is estimated to cost over $150 billion. If there needs to be another short-term patch for the Doc Fix Tribes are asking that SDPI be included in that reauthorization.

Please visit www.nihb.org/sdpi for more information on how you can be involved in SDPI renewal for 2015!

Posted - January 29, 2015

"Our People continue to live sicker and die younger than other Americans," said the National Indian Health Board before Senate Committee on Indian Affairs January 28th Hearing - highlighting Native American priorities for the 114th Congress

WASHINGTON, D.C. - On Wednesday, January 28, the Senate Committee on Indian Affairs held its first hearing during the 114th Congress to gain an overview of American Indian and Alaska Native priority issues. National Indian Health Board (NIHB) Executive Director Stacy A. Bohlen (Sault Ste. Marie Chippewa) testified before the Senate Committee on Indian Affairs in an oversight hearing to explore "Indian Country Priorities for the 114th Congress."

Read Full Media Release

Posted - January 28, 2015

Congress Begins Early Consideration of Legislative Vehicle for SDPI

Last week, the House Energy and Commerce Committee began considering changes for the Medicare's physician payment formula -- also known as the "Doc Fix" -- as the current "patch" blocking cuts to Medicare doctors expires on March 31, 2015. During the meeting, the path forward on how to pay for this major legislation remained unclear.

The Doc Fix is typically the legislative vehicle that contains renewal for the Special Diabetes Program for Indians (SDPI) as part of what are known as the "Medicare Extenders." In recent years, SDPI has only received one-year renewals because the Doc Fix bill has only received short-term patches.

NIHB and other SDPI Advocates from across Indian Country will be meeting with their Members of Congress in the coming months to support long-term SDPI renewal as part of the "Doc Fix" by March 31. Please visit www.nihb.org/sdpi for more information in SDPI including fact sheets on the program, or contact Caitrin Shuy, NIHB's Director of Congressional Relations, if you would like to become more involved in SDPI advocacy efforts at [email protected] or 202-507-4085.

Posted - January 20, 2015

Legislation Introduced to provide for Advance Appropriations for the Indian Health Service

On Wednesday, January 14, Congressman Don Young (R-AK) introduced H.R. 395 which would provide for Advance Appropriations for the Indian Health Service (IHS). Tribes and Tribal organizations have been supporting this change in the way IHS is funded in order to achieve better stability in how our health care is funded.

Advanced appropriations would mean Tribal and IHS facilities would know their funding levels one year in advance, but the funds would not be drawn down until the year in which it was spent. Congress uses a similar funding procedure for the Veterans' Health Administration. Advance appropriations would allow Indian health programs to effectively and efficiently manage budgets, coordinate care, and improve health quality outcomes for American Indians and Alaska Natives.

But in order to see this legislation enacted, we will need help from you! NIHB and its partners are encouraging Tribes to pass resolutions and send letters to Congress in support of this important issue in order to demonstrate widespread support in Indian Country. We are also encouraging you to share your story on how funding delays have impacted health care delivery at your Tribe. Click here to learn more.

Posted - January 13, 2015

House of Representatives Passes two bills aimed at employers under Obamacare

Last week, the U.S. House of Representatives passed two measures that would affect employers under the Affordable Care Act (ACA). The first bill, the "Hire more Heroes Act," would tweak the law so that veterans who are hired by businesses would not count toward the company's total number of employees under the ACA. (Under the law, employers, including Tribal governments, with more than 50 employees must provide health insurance to their workers or face fines.) This change would be premised mainly on the basis of Veterans already having health insurance coverage options through the Department of Defense or the Veterans' Administration. This legislation passed with a wide majority and is expected to head to the Senate, but it is unclear if President Obama would sign the legislation into law.

The second piece of legislation that passed the House is H.R. 30, which passed the House last Thursday by a vote of 252-172. It would adjust the ACA so that a "full-time" employee would be established at 40 hours per week, instead of 30 hours per week. The law currently requires that employees who work more than 30 hours weekly to be considered full-time when employers are determining their size for coverage purposes - including the mandate requiring them to provide coverage. Many small employers have argued that this threshold of 30 hours per week for full-time employees will discourage hiring and force them to cut hours. Supporters of the law argue that the bill will do significant harm to workers across the country by limiting coverage options. The President has indicated he would veto this legislation if it reaches his desk.

You can read more about these two bills here.

Posted - January 7, 2015

New Congress Convenes Today, Faces Many Challenges

Yesterday marked the start of the 114th Congress. It is the first time since 2006 where both chambers will be controlled by the Republican Party, but divisions remain within the party that might make passing legislation difficult. The Senate will have 13 new members while the House will have 60 new Members of Congress.

As we head into 2015, there are many deadlines and challenges that Congress must deal with and several of these will be important to Tribal communities. Appropriations for FY 2016 will continue to be a sticking point in the new Congress. The Budget Control Act of 2011 will provide for sequestration in FY 2016 unless a deal can be reached to ensure that federal spending remains below the statutory caps in the law. Republican leadership will have to decide if they will make an attempt to replace the cuts in part or in whole or write bills to the lower level. There is pressure to do both. NIHB will be educating the Congress in the coming weeks and months on Tribal health priorities for FY 2016. Tribes may also submit testimony to the House and Senate Appropriations Committees detailing your priorities. For your information, NIHB will send updates when information on submitting testimony is available.

On March 31, 2015, the current patch for the "Sustainable Growth Rate" or "Doc Fix" will expire. This is the legislation that governs the rates that physicians are paid by Medicare. It is also typically the legislative vehicle for the renewal for the Special Diabetes Program for Indians (SDPI). SDPI will expire on September 30, 2015 unless Congress acts. NIHB will be working tirelessly to educate Congress on the success of the SDPI program. Tribes across Indian Country have called for multi-year renewal to further sustainability of their programs. As in past years, that will largely depend on the ability of Congress to agree on a long-term "Doc Fix." Please visit www.nihb.org/sdpi for more information.

NIHB will also continue to educate Congress on key legislative priorities for Tribes in the new Congress. These include advance appropriations for the Indian Health Service, achieving a Medicare Like Rate for non-hospital Purchased/Referred Care at the Indian Health Service, and a legislative fix for the Definition of Indian in the Affordable Care Act.

For a general article on some of the upcoming challenges facing the new Congress please click here.

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Legislative Inquiries:

Caitrin Shuy
Director, Congressional Relations

910 Pennsylvania Ave, SE
Washington, DC 20003
Phone: 202-507-4085
Email: [email protected]