Indian Health Care Improvement Act Amendments of 2007

Floor Speech

INDIAN HEALTH CARE IMPROVEMENT ACT AMENDMENTS OF 2007 -- (Senate - February 14, 2008)

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Ms. CANTWELL. Mr. President, I rise in strong support of the Indian Health Care Improvement Act and the reauthorization we are considering today.

Passage of this bill in the Senate is long overdue. We haven't passed an update to the Indian Health Care Improvement Act since 1992, and the law has now been expired for 8 years.

Since this time, we have seen the continuation of unacceptable trends in the health of American Indians and Alaskan Natives. American Indians and Alaskan Natives across the country are 400 percent more likely to die from tuberculosis, 291 percent more likely to die from diabetes complications, and 67 percent more likely to die from influenza and pneumonia than other groups.

In my State of Washington, the average life expectancy of an American Indian is estimated to be 4 years below that of the general population, as reported by the Indian Health Service for the years 2000 through 2002. This is a troubling increase from the gap of 2.8 years reported by the Indian Health Service for 1994.

These disparities must not continue. We owe it to Indian Country to make good on our promise--a promise embedded in long-standing trust agreements--to ensure that the health needs of American Indians and Alaskan Natives are taken care of.

Enactment of this bill, of which I am a proud cosponsor, is a necessary step that will help us fully realize our obligations. The Indian Health Care Improvement Act must be reauthorized, and most importantly, modernized to ensure that the services delivered under the Indian Health Service reflect the advances made in health care delivery.

This reauthorization makes much needed improvements to the way health care is administered to American Indians. It makes new authorizations for home and community based care, a cost-effective and much desired alternative to traditional long-term care facilities. It expands behavioral health services to address disorders beyond the traditional focus on alcohol and substance abuse. And it requires that individuals in need of mental help get access to a continuum of care such as hospitalization and detoxification services.

Importantly, this bill includes long-term reauthorization of health services for urban Indians. As my colleagues know, urban Indians account for a vast majority of the American Indian population, with nearly 7 out of 10 American Indians and Alaskan Natives living in or near an urban area.

Such a large population cannot be left behind in this reauthorization. Urban Indians face similar health disparities as their counterparts who live on reservations, and they are not removed from our Nation's trust obligation because of where they live.

Washington State is grateful for the efforts of two urban Indian organizations working to provide critically needed health care to this underserved population. The Seattle Indian Health Board and the N.A.T.I.V.E. Project of Spokane have remained strong components of our State's health and social safety net, providing over 15,000 unique patients with comprehensive primary care, mental health, and social services.

The Seattle Indian Health Board also serves as a vital health research and surveillance center for the country under its Urban Indian Health Institute program. There is much to be learned about the issues and barriers facing urban Indians, making the comprehensive collection and analysis of information from this program indispensible to our work to improve the health of our communities.

Continuing Federal support for these and the other 32 entities currently receiving Federal resources for urban Indian health care must remain a top priority under this Government's strategy to address the disparities facing all American Indians.

I am excited that we have come so close to passing this reauthorization. I hope to work with Chairman Dorgan, Vice Chairman Murkowski, and my colleagues on the Indian Affairs and Finance Committees to seeing this through and getting a bill signed into law.

However, I want to also urge my colleagues to remember that our trust responsibility does not end with reauthorization of the Indian Health Care Improvement Act. It continues as we craft a budget for the coming fiscal year and make the appropriations for the Indian Health Service. The programs we are about to reauthorize are useless if we don't make gains in the paltry amount of funds for health services, urban Indian health, and facilities construction. As my colleagues know, the Indian Health Service is only funded at 60 percent of estimated need.

Today's actions should be the beginning of a renewed commitment to our first Americans. I look forward to starting a new chapter in our relationship with Indian Country.

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